Evaluation of the hemostatic effect of endoscopic cyanoacrylate injection in esophageal variceal jet bleeding

doi:10.3877/cma.j.issn.2095-2015.2025.05.014

Abstract

Abstract:

Objective

To investigate the hemostatic effect and safety of endoscopic cyanoacrylate injection on esophageal variceal jet bleeding.

Methods

Clinical data of 44 patients with esophageal variceal jet bleeding admitted to the 960th Hospital of Chinese PLA Joint Logistics Support Force From December 2014 to July 2024 were retrospectively analyzed, and they were divided into ligation group (24 cases) and cyanoacrylate injection group (20 cases) according to different endoscopic hemostasis methods. The success rate of hemostasis, the time required for hemostasis, the incidence of re-bleeding within 14 days after surgery, and the incidence of complications of the two groups were compared.

Results

The success rate of hemostasis in the cyanoacrylate injection group was 90.0%, which was similar to 91.7% in the ligation group, with no statistically significant difference (P>0.05). The time required for hemostasis in cyanoacrylate injection group was shorter than that in ligation group [(2.67±2.26) min vs. (6.40±3.20) min], with a statistically significant difference (P<0.05). The rebleeding rate within 14 days after operation (10.0% vs. 8.3%) and complication rate were similar between the two groups, with no statistical significance (P>0.05).

Conclusion

Endoscopic cyanoacrylate injection is a safe and effective treatment for esophageal variceal jet bleeding.

Key words: Esophageal varices bleeding, Endoscopic injection of tissue glue for esophageal varices, Cyanoacrylate, Therapeutic effect

Minghui Wang, Qun Li, Wenbo Li, Jing Wang, Zengyi Ma, Wenming Wu, Lingmin Li, Baojuan Zhang, Kuilin Sun, Xiaofeng Liu. Evaluation of the hemostatic effect of endoscopic cyanoacrylate injection in esophageal variceal jet bleeding[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2025, 15(05): 499-503.

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References 25

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组别	例数	性别[例(%)]		年龄(岁,±s)	肝硬化病因
组别	例数	男	女	年龄(岁,±s)	肝炎性	酒精性	自身免疫性	其他
套扎组	24	15(62.5)	9(37.5)	52.3±10.5	18(75.0)	1(4.2)	0(0)	5(20.8)
组织胶注射组	20	14(70.0)	6(30.0)	53.7±11.8	11(55.0)	3(15.0)	1(5.0)	5(25.0)
t/χ²/Z		0.273		-0.416
P		0.601		0.679	0.324
组别	例数	凝血酶原时间(s,±s)	白蛋白(g/L,±s)	总胆红素(μmol/L,±s)	Child-Pugh评分(±s)	Child-Pugh分级[例(%)]
组别	例数	凝血酶原时间(s,±s)	白蛋白(g/L,±s)	总胆红素(μmol/L,±s)	Child-Pugh评分(±s)	A级	B级	C级
套扎组	24	14.75±2.40	30.53±6.27	21.21±8.73	7.21±1.45	9(37.5)	14(58.3)	1(4.2)
组织胶注射组	20	15.20±2.73	30.06±5.37	28.62±27.75	7.85±1.57	6(30.0)	11(55.0)	3(15.0)
t/χ²/Z		-0.576	0.266	-1.147	-1.398	-0.896
P		0.568	0.791	0.264	0.169	0.370

组别	例数	性别[例(%)]		年龄(岁,±s)	肝硬化病因
组别	例数	男	女	年龄(岁,±s)	肝炎性	酒精性	自身免疫性	其他
套扎组	24	15(62.5)	9(37.5)	52.3±10.5	18(75.0)	1(4.2)	0(0)	5(20.8)
组织胶注射组	20	14(70.0)	6(30.0)	53.7±11.8	11(55.0)	3(15.0)	1(5.0)	5(25.0)
t/χ²/Z		0.273		-0.416
P		0.601		0.679	0.324
组别	例数	凝血酶原时间(s,±s)	白蛋白(g/L,±s)	总胆红素(μmol/L,±s)	Child-Pugh评分(±s)	Child-Pugh分级[例(%)]
组别	例数	凝血酶原时间(s,±s)	白蛋白(g/L,±s)	总胆红素(μmol/L,±s)	Child-Pugh评分(±s)	A级	B级	C级
套扎组	24	14.75±2.40	30.53±6.27	21.21±8.73	7.21±1.45	9(37.5)	14(58.3)	1(4.2)
组织胶注射组	20	15.20±2.73	30.06±5.37	28.62±27.75	7.85±1.57	6(30.0)	11(55.0)	3(15.0)
t/χ²/Z		-0.576	0.266	-1.147	-1.398	-0.896
P		0.568	0.791	0.264	0.169	0.370

组别	例数	止血成功[例(%)]	止血所需时间(min,±s)	术后14 d内再出血[例(%)]
套扎组	24	22(91.7)	6.40±3.20	2(8.3)
组织胶注射组	20	18(90.0)	2.67±2.26	2(10.0)
t/χ²		0	3.690	0
P		1	0.001	1

组别	例数	止血成功[例(%)]	止血所需时间(min,±s)	术后14 d内再出血[例(%)]
套扎组	24	22(91.7)	6.40±3.20	2(8.3)
组织胶注射组	20	18(90.0)	2.67±2.26	2(10.0)
t/χ²		0	3.690	0
P		1	0.001	1

组别	例数	食管狭窄	异位栓塞	发热	穿孔	胸痛	胸腔积液
套扎组	24	0	0	5(20.8)	0	5(20.8)	1(4.2)
组织胶注射组	20	0	0	7(35.0)	0	1(5.0)	3(15.0)
χ²				1.104		1.172	0.516
P				0.293		0.279	0.473

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