Kobe E, Zipprich B, Schentke K U, Nilius R
Department of Medicine, Medical Academy, Dresden, GDR.
Endoscopy. 1990 Nov;22(6):245-8. doi: 10.1055/s-2007-1012862.
Sixty-three patients with degree III or IV esophageal varices and the so-called red color sign, but without previous bleeding were randomly assigned to either prophylactic sclerotherapy (PST) (n = 30) or to a control group (n = 33). In 58 cases the portal hypertension was caused by liver cirrhosis (40% alcoholics). The two groups were comparable with respect to demographic data and endoscopic appearance, causes and severity of liver damage. Sclerotherapy was performed as combined intra-and paravariceal injections of 2 or 3% polidocanol. All patients, both in the treatment and in the control groups, who bled from varices after randomization, received sclerotherapy until the varices were eradicated, and remained in their groups. After a mean follow-up of 44.5 months, the bleeding rate in the PST group was significantly lower (30% vs 75%, p less than 0.01). The difference became significant from the second year onward. Fourteen patients of the PST group and 19 of the controls died (4 and 14, respectively, p less than 0.05 as a result of the bleeding). Life table analysis (Kaplan-Meier) revealed no differences in survival between the two groups. At the present time PST cannot yet be recommended as a method for clinical routine use.
63例患有III级或IV级食管静脉曲张且有所谓红色征但既往未出血的患者被随机分为预防性硬化治疗组（PST）（n = 30）或对照组（n = 33）。58例门静脉高压由肝硬化引起（40%为酒精性肝硬化）。两组在人口统计学数据、内镜表现、肝损伤的原因和严重程度方面具有可比性。硬化治疗采用2%或3%聚多卡醇进行静脉内和静脉旁联合注射。随机分组后，治疗组和对照组中所有因静脉曲张出血的患者均接受硬化治疗，直至静脉曲张消除，并留在各自组中。平均随访44.5个月后，PST组的出血率显著较低（30%对75%，p<0.01）。从第二年起差异变得显著。PST组有14例患者死亡，对照组有19例患者死亡（分别为4例和14例，因出血导致p<0.05）。生存曲线分析（Kaplan-Meier）显示两组之间的生存率无差异。目前，PST尚不能作为临床常规使用的方法推荐。
