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非肝硬化性门脉纤维化患者静脉曲张出血后的硬化治疗

Sclerotherapy after variceal hemorrhage in noncirrhotic portal fibrosis.

作者信息

Bhargava D K, Dwivedi M, Dasarathy S, Sundaram K R

机构信息

Department of Gastroenterology and Biostatistics, All India Institute of Medical Sciences, New Delhi.

出版信息

Am J Gastroenterol. 1989 Oct;84(10):1235-8.

PMID:2801673
Abstract

Sixty patients with variceal bleeding due to noncirrhotic portal fibrosis were treated by repeated endoscopic injection sclerotherapy. During each session, the varices were injected with a mean volume of 14.4 ml of 1% polidocanol intravariceally. This decreased rebleeding, as evidenced by a reduction in mean bleeding risk factor and transfusion requirement. Difference between pre- and post-sclerotherapy parameters were significant (p less than 0.001). Variceal obliteration was achieved in 53 (88%) patients. The mean sclerotherapy sessions required for eradication were 8.43 (SD = 2.41). Minor complications related to the procedure occurred in 12% of patients. Cumulative survival for 5 yr was 86%. Survival was significantly related to Child's status, being 97.5% for Child's A and 64% for Child's B patients. Recurrence of varices occurred in 15% of patients after a mean interval of 19 months. We conclude that endoscopic sclerotherapy is an effective method of treatment for variceal bleeding due to non-cirrhotic portal fibrosis, and is a reasonable alternative to surgery.

摘要

60例非肝硬化性门脉纤维化所致静脉曲张出血患者接受了反复内镜下注射硬化疗法治疗。在每次治疗过程中,向静脉曲张内平均注射14.4毫升1%聚多卡醇。这降低了再出血率,平均出血风险因素和输血需求的降低证明了这一点。硬化治疗前后参数的差异具有显著性(p小于0.001)。53例(88%)患者实现了静脉曲张闭塞。根除所需的平均硬化治疗次数为8.43次(标准差=2.41)。12%的患者出现了与该操作相关的轻微并发症。5年累计生存率为86%。生存率与Child分级显著相关,Child A级患者为97.5%,Child B级患者为64%。15%的患者在平均19个月的间隔后出现静脉曲张复发。我们得出结论,内镜下硬化疗法是治疗非肝硬化性门脉纤维化所致静脉曲张出血的有效方法,是一种合理的手术替代方法。

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