Clinical value and effect on haemodynamics of portal system of sclerotherapy combined with endoscopic injection of tissue adhesive for esophagogastric varices
AIM:To investigate the effects of sclerotherapy, endoscopic injection of tissue adhesive alone and combine them in the treatment of esophagogastric varices. METHODS:A total of 147 cases with from esophagogastric variees were randomly assigned to receive emergent endoscopic variceal sclerotherapy alone(sclerotherapy alone group, 75 cases), injection of tissue adhesive alone(tissue adhesive alone group, 34 cases)and combine sclerotherapy with injection of tissue adhesive(combine sclerotherapy with tissue adhesive group, 38 cases). The recent effective hemostatic rates, the eradicative rates and the early, late relapsed bleeding rates were observed. Color Doppler sonography was employed to measure the dynamical changes of portal vein and its branch vein before and after endoscopic treatment. Including the inside diameter, blood flow velocity and blood flow rate of portal vein, spleen vein, left gastric vein,umbilical vein and mesenteric vein. RESULTS:The recent effective hemostatic rates and the eradicative rates of combine sclerotherapy with tissue adhesive group were higher than that of other two groups and there were no significant difference among the rate of syndrome in 3 groups. The early relapsed bleeding rates and the late relapsed bleeding rates in 3 groups were significantly different, the highest was tissue adhesive alone group. The inside diameter of portal vein in 3 groups decreased after treatment and that of spleen vein increased,but there were not significantly different compared with before treatment. The inside diameter of other branch were not significantly different, too. The blood flow velocity and blood flow rate of portal vein and spleen vein increased significantly compared with before treatment and that of other branch were not significantly different. CONCLUSION:Combined sclerotherapy with endoscopic injection of tissue adhesive is more effective and safer for EGVB in controlling active bleeding, eradicative rate and the relapsed bleeding rates. After treatment, the pressure of protal vein don't increase and the blood flow velocity and blood flow rate could increased. There wasn't influence for the branch of portal vein.