Application of early endoscopic hemostasis in ulcer bleeding after cyanoacrylate injection for gastric varices

doi:10.3877/cma.j.issn.2095-2015.2026.02.010

Abstract

Abstract:

Objective

To investigate the efficacy and safety of early endoscopic hemostasis for ulcer bleeding after cyanoacrylate injection in gastric varices.

Methods

The clinical data of patients with ulcer bleeding after cyanoacrylate injection treated in the 960th Hospital of Chinese PLA Joint Logistics Support Force from August 2015 to February 2024 were retrospectively analyzed, and they were divided into control group and observation group according to different treatment methods. The control group received conservative drug treatment after admission, and the observation group received endoscopic hemostatic treatment within 48 hours after admission in addition to drug treatment. The success rate of hemostasis, hemostatic time, early rebleeding rate, late rebleeding rate and complication rate between the two groups were compared.

Results

A total of 61 patients were included in the study, 31 in the control group and 30 in the observation group. The success rate of hemostasis in the observation group was 100.0%, higher than that in the control group (80.6%). The average hemostasis time in the observation group was (1.23±0.43) days, shorter than that in the control group which was (2.58±0.72) days. The early rebleeding rate in the observation group was 3.3%, lower than that in the control group (28.0%), with statistically significant differences (P<0.05). There were no statistically significant differences in the rate of late rebleeding and complication between the two groups (P>0.05).

Conclusion

For patients with ulcer bleeding after cyanoacrylate injection for gastric varices, early endoscopic hemostasis treatment, compared with conservative drug therapy, can increase the success rate of hemostasis, shorten the hemostasis time, and reduce the early rebleeding rate. It is a safe and effective treatment method.

Key words: Esophageal-gastric varix, Cyanoacrylate, Haemostasis, Therapeutic effect

Minghui Wang, Wenbo Li, Qun Li, Zengyi Ma, Wenming Wu, Jing Wang, Kuilin Sun, Baojuan Zhang, Xiaofeng Liu. Application of early endoscopic hemostasis in ulcer bleeding after cyanoacrylate injection for gastric varices[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2026, 16(02): 151-155.

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References 20

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组别	例数	性别[例(%)]		年龄	白蛋白(g/L,±s)	总胆红素(μmol/L,±s)	凝血酶原时间(s,±s)	血小板(×10⁹/L,±s)	Child-Pugh评分(±s)
组别	例数	男	女	年龄	白蛋白(g/L,±s)	总胆红素(μmol/L,±s)	凝血酶原时间(s,±s)	血小板(×10⁹/L,±s)	Child-Pugh评分(±s)
对照组	31	23	8	54.6±8.7	32.71±4.61	20.66±14.79	15.05±2.65	88.87±56.29	7.00±1.67
观察组	30	19	11	56.1±11.7	31.42±6.04	25.58±16.34	15.04±2.19	104.14±73.77	7.70±1.51
χ²/t/Z		0.838		-0.590	0.940	-1.233	0.008	-0.905	-1.712
P		0.360		0.558	0.351	0.222	0.993	0.369	0.092
组别	例数	Child-Pugh分级[例(%)]			入院前失血量[例(%)]			Sarin分型[例(%)]
组别	例数	A级	B级	C级	轻度	中度	重度	GOV1	GOV2	IGV1
对照组	31	13	16	2	18	10	3	22	7	2
观察组	30	8	19	3	16	10	4	20	9	1
χ²/t/Z		-1.249			-0.438
P		0.211			0.661			0.746^*

组别	例数	性别[例(%)]		年龄	白蛋白(g/L,±s)	总胆红素(μmol/L,±s)	凝血酶原时间(s,±s)	血小板(×10⁹/L,±s)	Child-Pugh评分(±s)
组别	例数	男	女	年龄	白蛋白(g/L,±s)	总胆红素(μmol/L,±s)	凝血酶原时间(s,±s)	血小板(×10⁹/L,±s)	Child-Pugh评分(±s)
对照组	31	23	8	54.6±8.7	32.71±4.61	20.66±14.79	15.05±2.65	88.87±56.29	7.00±1.67
观察组	30	19	11	56.1±11.7	31.42±6.04	25.58±16.34	15.04±2.19	104.14±73.77	7.70±1.51
χ²/t/Z		0.838		-0.590	0.940	-1.233	0.008	-0.905	-1.712
P		0.360		0.558	0.351	0.222	0.993	0.369	0.092
组别	例数	Child-Pugh分级[例(%)]			入院前失血量[例(%)]			Sarin分型[例(%)]
组别	例数	A级	B级	C级	轻度	中度	重度	GOV1	GOV2	IGV1
对照组	31	13	16	2	18	10	3	22	7	2
观察组	30	8	19	3	16	10	4	20	9	1
χ²/t/Z		-1.249			-0.438
P		0.211			0.661			0.746^*

组别	例数	止血成功[例(%)]	止血时间(d,±s)
对照组	31	25(80.6)	2.58±0.72
观察组	30	30(100.0)	1.23±0.43
χ²/t		4.442	8.906
P		0.035	<0.001

组别	例数	止血成功[例(%)]	止血时间(d,±s)
对照组	31	25(80.6)	2.58±0.72
观察组	30	30(100.0)	1.23±0.43
χ²/t		4.442	8.906
P		0.035	<0.001

组别	例数	早期再出血	晚期再出血
对照组	25	7(28.0)	6(24.0)
观察组	30	1(3.3)	8(26.7)
χ²		4.838	0.051
P		0.028	0.821

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