Goff J S, Reveille R M, Stiegmann G V
Department of Medicine, University of Colorado Health Science Center, Denver.
Endoscopy. 1992 Jun;24(5):401-4. doi: 10.1055/s-2007-1010507.
Endoscopic variceal ligation (EVL) was developed as an alternative to endoscopic variceal sclerosis (ES) because of the high complication rate seen with ES. The new technique involves placement of small elastic bands around the variceal channels in the distal esophagus. The first 146 consecutive patients treated with EVL during the period from August, 1986 to July, 1989 are reported. Portal hypertension was caused by alcoholic liver disease in 93 of these patients. The average age of the patients was 53 years and 66% were males. All of the patients had recently bled from esophageal varices. At the time of treatment, 23% of the patients were actively bleeding. They were all treated acutely with EVL and had repeated treatments with the long-term goal of variceal eradication. The overall survival was 73%. Varices were eradicated or reduced to grade one in 78% of the 125 patients who were followed for more than 30 days. Variceal eradication required a mean of 5.5 sessions. Recurrent bleeding occurred in 44% of the total patient population. There were no major complications from EVL. It is concluded from this non-randomized experience that EVL is an effective treatment for bleeding esophageal varices and that it appears to be as effective as sclerotherapy with fewer complications.
由于内镜下静脉曲张硬化术（ES）并发症发生率高，内镜下静脉曲张套扎术（EVL）应运而生作为其替代方法。这项新技术是在食管远端的曲张静脉周围放置小的弹性扎带。本文报告了1986年8月至1989年7月期间连续接受EVL治疗的首批146例患者。其中93例患者的门静脉高压由酒精性肝病引起。患者的平均年龄为53岁，66%为男性。所有患者近期均有食管静脉曲张出血。治疗时，23%的患者正在出血。他们均接受了EVL紧急治疗，并为实现静脉曲张根除的长期目标而接受了重复治疗。总体生存率为73%。在125例随访超过30天的患者中，78%的患者静脉曲张被根除或降至一级。静脉曲张根除平均需要5.5次治疗。44%的患者出现复发性出血。EVL未出现重大并发症。从这项非随机研究经验得出的结论是，EVL是治疗食管静脉曲张出血的有效方法，而且它似乎与硬化疗法效果相同，但并发症更少。
