Risk Factors for Glue Extrusion Bleeding After Endoscopic Injection of Cyanoacrylate Glue for Gastric Varices: A Retrospective Study of 269 Patients.

IF 2.5 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Digestive Diseases and Sciences Pub Date : 2025-03-31 DOI:10.1007/s10620-025-08999-9

Yihuan Hu, Mei Zhou, Deliang Liu, Jian Gong

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引用次数: 0

Abstract

Background: Glue extrusion bleeding is a major complication of endoscopic cyanoacrylate glue injection for the treatment of gastric varices. However, its risk factors remain unclear.

Aims: This retrospective study aimed to evaluate the risk factors for bleeding associated with glue extrusion.

Methods: This study analyzed the medical data of cirrhotic patients who underwent endoscopic obliteration for gastric varices using cyanoacrylate glue between January 2016 and December 2022. The data within 1 year after therapy were carried out with logistic regression. A nomogram model was constructed based on the factors.

Results: 269 patients were enrolled. Risk factors associated with glue extrusion bleeding included the volume of the glue (≥ 4 mL)(OR 1.289, 95% CI 1.051-1.580; P = 0.015), massive ascites (OR 5.645, 95% CI 2.260-14.097; P = 0.000), active hemorrhage during endoscopy (OR 2.830, 95% CI 1.284-6.234; P = 0.010), and the use of β-blockers was a protective factor (OR 0.185, 95% CI 0.07-0.485; P = 0.001). The nomogram model had good prediction accuracy, with an area under the curve of 0.74 (95% CI 0.658-0.822; P < 0.001).

Conclusion: Massive ascites, active hemorrhage during endoscopy, glue volume ≥ 4 mL, and the use of β-blockers are associated with glue extrusion bleeding. At-risk patients may benefit from controlling the volume of the glue, undergoing endoscopic ultrasound and using β-blockers.

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269例胃静脉曲张腔内注射氰基丙烯酸酯胶后胶挤出出血的危险因素回顾性研究

背景：胶挤出出血是内镜下注射氰基丙烯酸酯胶治疗胃静脉曲张的主要并发症。然而，其风险因素仍不清楚。目的：本回顾性研究旨在评估胶挤压出血相关的危险因素。方法：本研究分析2016年1月至2022年12月期间应用氰基丙烯酸酯胶行胃静脉曲张内镜闭塞术的肝硬化患者的医疗资料。对治疗后1年内的数据进行logistic回归分析。基于各因素构建了nomogram模型。结果：269例患者入组。与胶挤出出血相关的危险因素包括胶的体积（≥4 mL）(OR 1.289, 95% CI 1.051-1.580；P = 0.015)，大量腹水(OR 5.645, 95% CI 2.260-14.097；P = 0.000)，内镜检查时活动性出血(OR 2.830, 95% CI 1.284-6.234；P = 0.010)， β受体阻滞剂的使用是一个保护因素(OR 0.185, 95% CI 0.07-0.485；p = 0.001)。模态图模型具有较好的预测精度，曲线下面积为0.74 (95% CI 0.658-0.822；P结论：大量腹水、内镜下活动性出血、胶量≥4 mL及β受体阻滞剂的使用与胶挤压出血相关。有风险的患者可以通过控制胶水的体积、进行内窥镜超声检查和使用β受体阻滞剂来获益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Digestive Diseases and Sciences 医学-胃肠肝病学

CiteScore

6.40

自引率

3.20%

发文量

420

审稿时长

1 months

期刊介绍： Digestive Diseases and Sciences publishes high-quality, peer-reviewed, original papers addressing aspects of basic/translational and clinical research in gastroenterology, hepatology, and related fields. This well-illustrated journal features comprehensive coverage of basic pathophysiology, new technological advances, and clinical breakthroughs; insights from prominent academicians and practitioners concerning new scientific developments and practical medical issues; and discussions focusing on the latest changes in local and worldwide social, economic, and governmental policies that affect the delivery of care within the disciplines of gastroenterology and hepatology.