Chawla Y K, Dilawari J B, Ramesh G N, Kaur U, Mitra S K, Walia B N
Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Gut. 1990 Feb;31(2):213-6. doi: 10.1136/gut.31.2.213.
One hundred and twenty two patients who presented with variceal bleeding as a result of extrahepatic portal vein obstruction (EHPO) were entered into the sclerotherapy programme with a mean follow up of 23.69 months (range four to 60 months). Eighteen (14.7%) patients were lost to follow up, three (2.4%) patients underwent surgery, and six (4.9%) patients died. Variceal obliteration was achieved in the remaining 95 patients requiring 5.4 (2.4) sessions of sclerotherapy (range 2-18). Seventeen episodes of upper gastrointestinal bleed occurred in 15 patients during sclerotherapy. Recurrence of oesophageal varices was seen in 15 patients. Ten patients developed bulbous gastric varices after obliteration. Major complications including perforation and strictures were seen more commonly in children. Sclerotherapy was associated with a significant reduction in the bleeding rate (bleeds/month/patient) as compared with the presclerotherapy period (p less than 0.001). Endoscopic sclerotherapy is an effective and safe modality in the prevention of variceal bleeds in patients with extrahepatic portal vein obstruction.
122例因肝外门静脉阻塞（EHPO）导致静脉曲张出血的患者进入硬化治疗项目，平均随访23.69个月（范围4至60个月）。18例（14.7%）患者失访，3例（2.4%）患者接受了手术，6例（4.9%）患者死亡。其余95例患者实现了静脉曲张闭塞，需要5.4（2.4）次硬化治疗（范围2至18次）。15例患者在硬化治疗期间发生了17次上消化道出血。15例患者出现食管静脉曲张复发。10例患者在闭塞后出现球部胃静脉曲张。包括穿孔和狭窄在内的主要并发症在儿童中更为常见。与硬化治疗前相比，硬化治疗使出血率（出血/月/患者）显著降低（p<0.001）。内镜硬化治疗是预防肝外门静脉阻塞患者静脉曲张出血的一种有效且安全的方式。
