小剂量硬化剂行曲张静脉内硬化疗法联合食管黏膜硬化疗法对肝硬化高静脉曲张压力患者的疗效
Effect of intravariceal sclerotherapy combined with esophageal mucosal sclerotherapy using small-volume sclerosant for cirrhotic patients with high variceal pressure.
作者信息
Kong De-Run, Wang Jin-Guang, Chen Chen, Yu Fang-Fang, Wu Qiong, Xu Jian-Ming
机构信息
De-Run Kong, Jin-Guang Wang, Chen Chen, Fang-Fang Yu, Qiong Wu, Jian-Ming Xu, Department of Gastroenterology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China.
出版信息
World J Gastroenterol. 2015 Mar 7;21(9):2800-6. doi: 10.3748/wjg.v21.i9.2800.
AIM
To explore the effect of intravariceal-mucosal sclerotherapy using small dose of sclerosant on the recurrence of esophageal varices.
METHODS
We randomly assigned 38 cirrhotic patients with previous variceal bleeding and high variceal pressure (> 15.2 mmHg) to receive endoscopic variceal ligation (EVL) and combined intravariceal and esophageal mucosal sclerotherapy (combined group) using small-volume sclerosant. The end-points of the study were rebleeding and recurrence of esophageal varices.
RESULTS
During a median follow-up period of 16 mo, varices recurred in 1 patient in the combined group as compared with 7 patients in the EVL group (P = 0.045). Rebleeding occurred in 3 patients in the EVL group as compared with 1 patient in the combined group (P = 0.687). No patient died in the two groups. No significant differences were observed between the two groups with respect to serious adverse events.
CONCLUSION
Intravariceal-mucosal sclerotherapy using small dose of sclerosant is more effective than EVL in decreasing the incidence of variceal recurrence for cirrhotic patients.
目的
探讨使用小剂量硬化剂进行曲张静脉内黏膜硬化治疗对食管静脉曲张复发的影响。
方法
我们将38例既往有静脉曲张出血且曲张静脉压力较高（>15.2 mmHg）的肝硬化患者随机分为两组，分别接受内镜下静脉曲张套扎术（EVL）以及使用小剂量硬化剂进行曲张静脉内联合食管黏膜硬化治疗（联合组）。研究的终点为再出血和食管静脉曲张复发。
结果
在中位随访期16个月期间，联合组有1例患者静脉曲张复发，而EVL组有7例患者复发（P = 0.045）。EVL组有3例患者发生再出血，联合组有1例患者发生再出血（P = 0.687）。两组均无患者死亡。两组在严重不良事件方面未观察到显著差异。
结论
对于肝硬化患者，使用小剂量硬化剂进行曲张静脉内黏膜硬化治疗在降低静脉曲张复发率方面比EVL更有效。
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