Kitano S, Wada H, Tanoue K, Hashizume M, Koyanagi N, Sugimachi K
Department of Surgery II, Kyushu University, Faculty of Medicine, Fukuoka, Japan.
Hepatogastroenterology. 1992 Dec;39(6):546-8.
Sixty-six patients with portal hypertension and esophageal varices due to liver cirrhosis were randomized to receive either 5% ethanolamine oleate (EO) or 5% EO plus 1% polidocanol (EOP) as a sclerosant for endoscopic injection sclerotherapy (EIS). The two groups were well matched with regard to age, sex and the severity of liver disease. In no patient in the two groups was there any major complication, such as esophageal perforation or esophageal bleeding. Eradication of esophageal varices was attained with an average of 4.7 and 4.3 sessions of endoscopic injection sclerotherapy in the ethanolamine oleate and polidocanol groups, respectively. Data on one patient in the ethanolamine oleate group had to be excluded because he left the hospital after 2 sessions of endoscopic injection sclerotherapy. Esophageal ulcers occurred earlier in the polidocanol group (after an average of 2.8 weeks) than in the ethanolamine oleate group (3.8 weeks), the difference being statistically significant (P < 0.01). The rate of occurrence of esophageal stricture requiring more than 2 sessions of bougienage was significantly (P < 0.01) higher in the polidocanol group (16/33, 48%) than in the ethanolamine oleate group (4/32, 12%). This study suggests that the two sclerosants have equal efficacy for treating patients with esophageal varices. With polidocanol there was ulceration and stricture in the distal esophagus.
66例因肝硬化导致门静脉高压和食管静脉曲张的患者被随机分为两组，分别接受5%油酸乙醇胺（EO）或5%油酸乙醇胺加1%聚多卡醇（EOP）作为硬化剂进行内镜注射硬化治疗（EIS）。两组在年龄、性别和肝病严重程度方面匹配良好。两组均未出现任何重大并发症，如食管穿孔或食管出血。油酸乙醇胺组和聚多卡醇组分别平均通过4.7次和4.3次内镜注射硬化治疗实现了食管静脉曲张的根除。油酸乙醇胺组有1例患者在接受2次内镜注射硬化治疗后出院，该患者的数据被排除。聚多卡醇组食管溃疡出现时间早于油酸乙醇胺组（分别为平均2.8周和3.8周），差异有统计学意义（P<0.01）。需要进行超过2次探条扩张术的食管狭窄发生率，聚多卡醇组（16/33，48%）显著高于油酸乙醇胺组（4/32，12%）（P<0.01）。本研究表明，两种硬化剂治疗食管静脉曲张患者的疗效相当。使用聚多卡醇会出现食管远端溃疡和狭窄。
