Specialized Interventional Care for Massive Esophagogastric Variceal Bleeding in Decompensated Cirrhosis: A Midlife Case Study

Objective: We wished to systematically summarize critical peri-procedural nursing strategies for a middle-aged patient with decompensated liver cirrhosis and esophagogastric variceal bleeding (EGVB) undergoing interventional treatments—specifically percutaneous transhepatic variceal embolization (PTVE) and a transjugular intrahepatic portosystemic shunt (TIPS)—and to develop evidence-based nursing protocols aimed at reducing complications and improving outcomes.

Methods: Nursing interventions were implemented within a multidisciplinary framework, emphasizing 1. Comprehensive preoperative assessment and preparation; 2. Real-time intraoperative coordination and monitoring; and 3. Rigorous postoperative management to prevent rebleeding, hepatic encephalopathy, and infection. Specialized care included precise puncture site management, continuous portal pressure monitoring, individualized nutritional support, psychological counseling, and targeted health education. The nursing plan was dynamically adjusted based on the patient’s clinical status.

Results: Following PTVE and TIPS, bleeding was effectively controlled; hemoglobin levels increased from 39 g/L to 85 g/L; liver function (total protein, albumin) progressively improved; and no severe complications (puncture site hematoma, hepatic encephalopathy, or stent thrombosis) occurred. Patient satisfaction reached 98%. The patient was discharged stably 24 days postoperatively and remained healthy during the 1-year follow-up.

Conclusion: Effective perioperative nursing for interventional EGVB management requires 1. Precise monitoring and proactive complication prevention; 2. Integrated multidisciplinary collaboration; and 3. Specialized attention to the portal pressure dynamics, coagulation parameters, and psychological well-being . This protocol establishes a replicable nursing model for similar cases.