Nozoe T, Matsumata T, Sugimachi K
Department of Gastroenterology, Saiseikai Yahata General Hospital, Kitakyushu, Japan.
J Gastroenterol Hepatol. 2000 Mar;15(3):320-3. doi: 10.1046/j.1440-1746.2000.02128.x.
Although dysphagia resulting from oesophageal strictures induced by endoscopic injection sclerotherapy (EIS) is not a fatal complication, it is often quite distressing for the patients. The aim of the current study was to clarify the relationship between dysphagia resulting from oesophageal stricture following prophylactic EIS and the volume of sclerosant consumed in the EIS series.
Fifty-two patients with oesophageal varices, who had been treated by prophylactic EIS, were selected as the subjects.
Seventeen (32.7%) patients developed dysphagia following prophylactic EIS, and five patients with a severe stricture required bougie dilatation to take meals. The volume of sclerosant used in the initial session of EIS for patients with subsequent dysphagia (24.9 +/- 4.0 mL) was significantly larger than that for patients without dysphagia (18.4 +/- 5.1 mL; P < 0.001). The mean volume of sclerosant consumed per session during the EIS series for patients with dysphagia (16.5 +/- 3.0 mL) was also significantly larger than that for patients without dysphagia (13.1 +/- 3.8 mL; P < 0.01).
The injection of a superfluous amount of sclerosant in prophylactic EIS brings about distressing dysphagia with oesophageal stricture in the patients with oesophageal varices who had no such complaint or symptoms before the therapy.
尽管内镜注射硬化疗法(EIS)所致食管狭窄引起的吞咽困难并非致命并发症,但对患者而言通常颇为痛苦。本研究旨在阐明预防性EIS后食管狭窄所致吞咽困难与EIS系列中硬化剂用量之间的关系。
选取52例接受预防性EIS治疗的食管静脉曲张患者作为研究对象。
17例(32.7%)患者在预防性EIS后出现吞咽困难,5例严重狭窄患者需用探条扩张才能进食。后续出现吞咽困难的患者在EIS首次治疗时使用的硬化剂用量(24.9±4.0 mL)显著高于未出现吞咽困难的患者(18.4±5.1 mL;P<0.001)。吞咽困难患者在EIS系列治疗期间每次所用硬化剂的平均用量(16.5±3.0 mL)也显著高于未出现吞咽困难的患者(13.1±3.8 mL;P<0.01)。
预防性EIS中注射过量硬化剂会使治疗前无此类主诉或症状的食管静脉曲张患者出现令人痛苦的食管狭窄性吞咽困难。