Tajiri T, Onda M, Toba M, Umehara M, Yoshida H, Kim D Y, Yamashita K
First Department of Surgery, Nippon Medical School, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 1992 Sep;93(9):1150-2.
To evaluate the efficacy of the embolization therapy (Emb) for varices, we performed endoscopic injection sclerotherapy (EIS) alone and EIS combined with Emb. Various embolizations such as percutaneous transhepatic obliteration, splenic artery embolization and left gastric artery embolization have been employed. The efficacy rates were 76.5% of the patients in the EIS alone and 87.5% in the EIS with Emb group (EIS+Emb). The cumulative percentages of rebleeding at one year and 3 years were 23.1%, 34.6% in EIS alone, and 10.7%, 25.0% in EIS+Emb respectively. Especially in the patients with the Child C, there was significant difference in the efficacy rates: 60.0% (EIS alone) versus 88.9% (EIS+Emb), and recurrence rates within one year: 41.7% (EIS alone) versus 12.5% (EIS+Emb) (p < 0.05) and length of treatment free periods: 9.7 months versus 17.5 months (p < 0.01). After the treatments, improvement of Child's criteria was seen to be better in EIS+Emb than in EIS alone. The similar results have been obtained in the patients with hepatocellular carcinoma and with gastric varices. These results suggest that EIS should be combined with Emb to increase durability and to improve general condition.
为评估栓塞疗法（Emb）治疗静脉曲张的疗效，我们分别进行了单纯内镜注射硬化疗法（EIS）以及EIS联合Emb治疗。已采用多种栓塞方法，如经皮经肝闭塞、脾动脉栓塞和胃左动脉栓塞。单纯EIS组患者的有效率为76.5%，EIS联合Emb组（EIS+Emb）为87.5%。单纯EIS组1年和3年再出血的累积百分比分别为23.1%、34.6%，EIS+Emb组分别为10.7%、25.0%。尤其是Child C级患者，有效率存在显著差异：单纯EIS组为60.0%，EIS+Emb组为88.9%；1年内复发率：单纯EIS组为41.7%，EIS+Emb组为12.5%（p<0.05）；无治疗期长度：分别为9.7个月和17.5个月（p<0.01）。治疗后，EIS+Emb组Child标准的改善情况优于单纯EIS组。肝细胞癌和胃静脉曲张患者也获得了类似结果。这些结果表明，EIS应与Emb联合使用，以提高疗效并改善总体状况。
