Miyoshi H, Tei H, Ashida K, Osaka N, Matsumoto A, Hirata I, Ohshiba S
Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan.
Gastroenterol Jpn. 1989 Oct;24(5):469-75. doi: 10.1007/BF02773871.
One hundred fifty-two patients with esophageal varices underwent a total of 485 injection sclerotherapy procedures (mean, 3.2 times per each case). During 5 years of observation, 20 cases (13.2%) died following injection sclerotherapy. The 3-year survival rates, based on the Kaplan-Meier method, were 42% for emergency cases, 75% for elective cases and 90% for prophylactic cases. Significant differences (P less than 0.05) by the generalized Wilcoxon test were observed in the survival rates between emergency cases and prophylactic cases, and also between elective cases and prophylactic cases. Two cases (8.6%) of failure to control acute hemostasis were experienced. Twenty cases of bleeding after sclerotherapy were experienced, and 8 died of bleeding. The three-year bleeding rate according to the Kaplan-Meier method was 59% for emergency cases, 25% for elective cases and 7% for prophylactic cases. A significant difference (P less than 0.05) by the generalized Wilcoxon test was observed in the bleeding rate between elective cases and prophylactic cases. Non-bleeding rate (100%-bleeding rate) after sclerotherapy showed almost the same values as the survival rate. These results indicate that upper digestive tract hemorrhage influences the prognosis of patients after sclerotherapy.
152例食管静脉曲张患者共接受了485次注射硬化治疗（平均每例3.2次）。在5年的观察期内，20例（13.2%）患者在注射硬化治疗后死亡。根据Kaplan-Meier法，急诊病例的3年生存率为42%，择期病例为75%，预防性病例为90%。广义Wilcoxon检验显示，急诊病例与预防性病例之间以及择期病例与预防性病例之间的生存率存在显著差异（P<0.05）。有2例（8.6%）未能控制急性出血。硬化治疗后有20例发生出血，其中8例死于出血。根据Kaplan-Meier法，急诊病例的3年出血率为59%，择期病例为25%，预防性病例为7%。广义Wilcoxon检验显示，择期病例与预防性病例之间的出血率存在显著差异（P<0.05）。硬化治疗后的无出血率（100% - 出血率）与生存率几乎相同。这些结果表明，上消化道出血影响硬化治疗后患者的预后。
