The effect of sclerotherapy of bleeding esophageal variceal on survival of cirrhotic patients.

Objective: To investigate the effect of various factors in sclerotherapy of cirrhotic esophageal variceal bleeding (CEVB) on the prognosis, model of survival was established.

Methods: Kaplan-Meier analysis was applied in patients with CEVB treated by sclerotherapy from April 1987 to June 2000 to evaluate the survival, with follow-up data of survival and 29 selected factors of prognosis. Risk factors were identified with Cox's Proportional Hazard Model.

Results: Cox's model shows that Child grading and outcome of varices are two factors that significantly influence the prognosis and survival. Survival of 1, 3 and 5 year for the entire group is 93.29%, 85.24% and 74.27%, respectively. Survival of 1 year for patients of Child grade A, B and C is 98.88%, 95.97% and 82.32%, respectively, and survival of 5 year is 91.42%, 78.35% and 49.48%, respectively, with significant difference in survival curves. Outcome of esophageal varices is labeled with elimination, basically elimination, degree I, degree II and degree III, and survival of 1 year is 96.08%, 93.94%, 85.84%, 85.00% and 53.85%, respectively, survival of 5 year is 81.45%, 67.76%, 72.89%, 61.59% and 35.90%, respectively, with significant difference in survival curves. In patients of Child grade C with outcome of elimination or basically elimination, 1 year survival is 88.24%, and 2 year survival is 77. 98% approximately 83.63%. Survival curves of stratified groups are tended to converge after 50 months.

Conclusions: Sclerotherapy for CEVB is an effective therapy to arrest emergent bleeding and prevent rebleeding. For patients of Child grade C,survival can also be prolonged, so it is advisable to take active measures. Repeat of sclerotherapy after about 4 years may be necessary. Sclerotherapy can significantly prolong the survival.