Assessment of bleeding risk for early anticoagulation after endoscopic cyanoacrylate injection in cirrhosis patients with gastric varices and portal vein thrombosis
10.12025/j.issn.1008-6358.2024.20240547
- VernacularTitle:肝硬化胃静脉曲张合并门静脉血栓患者内镜下组织胶注射治疗后早期抗凝的出血风险评估
- Author:
Huishan WANG
1
;
Ye FANG
;
Sitao YE
;
Xinghuan LI
;
Xiaoquan HUANG
;
Jian WANG
;
Lili MA
;
Shiyao CHEN
Author Information
1. 复旦大学附属中山医院消化科,上海 200032
- Keywords:
cirrhosis;
gastric varices;
portal vein thrombosis;
anticoagulation;
endoscopic cyanoacrylate injection
- From:
Chinese Journal of Clinical Medicine
2024;31(3):361-366
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effects of anticoagulation treatment to postoperative bleeding events in liver cirrhosis patients with gastric varices and portal vein thrombosis.Methods Patients diagnosed with portal vein thrombosis and treated with endoscopic cyanoacrylate injection at Zhongshan Hospital,Fudan University due to gastric variceal bleeding from January 2023 to December 2023 were included.Clinical data of patients were collected,and patients were divided into anticoagulant group and non-anticoagulant group based on whether anticoagulant treatment was performed within 48 h after treatment.Re-bleeding in patients was evaluated in 6 weeks of follow-up.Cox regression was used for univariate and multivariate analysis of re-bleeding within 6 weeks after treatment.Results A total of 160 patients were included,of whom 65 patients received anticoagulation treatment within 48 h after endoscopic cyanoacrylate injection.There were no statistically significant differences in gender,etiology of liver cirrhosis,dosage of cyanoacrylate and sclerosing agents,and Child-Pugh grading between the two groups.There was no statistically significant difference in re-bleeding rate within 6 weeks after treatment between the two groups(1.54％vs 1.05％,P=0.795).Multivariate Cox regression analysis showed that the large amount of cyanoacrylate was a risk factor for re-bleeding within 6 weeks after endoscopic treatment(HR=5.862,P=0.015).Conclusions For patients with liver cirrhosis,gastric varices,and portal vein thrombosis,who receive endoscopic cyanoacrylate injection,early anticoagulation does not increase the risk of re-bleeding after treatment,while a large amount of cyanoacrylate injection may be a risk factor for re-bleeding.However,sample should be increased to verify.
