Sanowski R A, Waring J P
VA Medical Center, Phoenix, AZ 85012.
J Clin Gastroenterol. 1989 Jun;11(3):247-52.
A number of techniques have been developed to control active upper gastrointestinal tract bleeding. These include thermal devices such as the laser, heater probe, and bipolar circumactive probe (BICAP). Although these devices have proved effective, they vary in cost and at times are cumbersome to use. A simple, inexpensive, readily available means of treating active bleeding from the gastrointestinal tract is injection of the lesion with a sclerosing substance. This method has proved helpful in stopping variceal hemorrhage, and the simplicity of the equipment and procedure makes it an outstanding candidate therapy for treating other causes of hemorrhage. Although the method is not well known in the United States, it has been applied in Japan and Europe. Most studies so far have been uncontrolled, but in over 700 patients reported in the world literature, effective initial hemostasis has been achieved in about 90% of patients overall. Success rates have been somewhat dependent on the site and rate of bleeding. No deaths have been reported from the procedure. We review the current status, techniques, and types of sclerosing agents and provide a detailed analysis of results of injection sclerotherapy. We propose that although the technique is simple, the effectiveness and routine application to the patient with upper gastrointestinal hemorrhage await careful controlled studies and comparison with other available hemostatic methods.
已经开发出多种技术来控制上消化道活动性出血。这些技术包括热装置，如激光、热探头和双极环行探头（BICAP）。尽管这些装置已被证明有效，但它们在成本上有所不同，而且有时使用起来很麻烦。一种简单、廉价且易于获得的治疗胃肠道活动性出血的方法是向病变部位注射硬化剂。这种方法已被证明有助于止住静脉曲张出血，而且设备和操作的简单性使其成为治疗其他出血原因的优秀候选疗法。尽管这种方法在美国并不广为人知，但它已在日本和欧洲得到应用。到目前为止，大多数研究都是非对照性的，但在世界文献报道的700多名患者中，总体上约90%的患者实现了有效的初始止血。成功率在一定程度上取决于出血部位和出血速度。该操作尚未有死亡报告。我们回顾了硬化剂的现状、技术和类型，并对注射硬化疗法的结果进行了详细分析。我们提出，尽管该技术简单，但对上消化道出血患者的有效性和常规应用仍有待仔细的对照研究，并与其他可用的止血方法进行比较。
