Nishikawa Y, Hosokawa Y, Doi T, Endo H, Tanimizu M, Hyodo I, Jinno K, Sakata T, Tomoda J
Department of Internal Medicine and Clinical Research, National Shikoku Cancer Center Hospital, Matsuyama, Japan.
J Gastroenterol. 1999 Apr;34(2):159-62. doi: 10.1007/s005350050237.
For more effective and simple endoscopic injection sclerotherapy (EIS) for esophageal varices, we developed an EIS procedure with ligation (EISL) that is non-invasive, in which EIS and endoscopic variceal ligation (EVL) are performed simultaneously. In this study, we compared EISL and EIS in a randomized sample of patients (n = 14 for each procedure). For EISL, EVL was performed, including the injection site, after the injection of 5% ethanolamine oleate with iopamidol (EOI) into a varix. The mean number of treatment sessions required for eradication of esophageal varices was 2.3+/-0.5 for EISL and 3.9+/-0.8 for EIS (P < 0.001); the mean number of treatment sites was 6.2+/-2.2 for EISL and 14.0+/-5.0 for EIS (P < 0.001); the mean total amount of EOI used was 13.8+/-5.2ml for EISL and 26.3+/-9.8ml for EIS (P < 0.001). There were no significant differences in rates of recurrence of varices or in bleeding between the two groups. For EISL, fewer treatment sessions and less sclerosant were sufficient, probably because the sclerosants were more effective due to the blockage of variceal blood flow by the ligation. This method should provide a novel modification of EIS.
为了使食管静脉曲张的内镜注射硬化疗法（EIS）更有效且更简便，我们开发了一种带有结扎术的EIS程序（EISL），该程序是非侵入性的，其中EIS和内镜下静脉曲张结扎术（EVL）同时进行。在本研究中，我们在随机抽取的患者样本（每种程序各14例）中比较了EISL和EIS。对于EISL，在将5%油酸乙醇胺与碘帕醇（EOI）注入静脉曲张后，对包括注射部位在内进行EVL。消除食管静脉曲张所需的平均治疗次数，EISL为2.3±0.5次，EIS为3.9±0.8次（P<0.001）；平均治疗部位数量，EISL为6.2±2.2个，EIS为14.0±5.0个（P<0.001）；EOI的平均总用量，EISL为13.8±5.2ml，EIS为26.3±9.8ml（P<0.001）。两组之间静脉曲张复发率或出血率无显著差异。对于EISL，较少的治疗次数和较少的硬化剂就足够了，可能是因为结扎术阻断了静脉曲张血流，使硬化剂更有效。该方法应为EIS提供一种新的改进。
