Witzel L, Wolbergs E, Merki H
Lancet. 1985 Apr 6;1(8432):773-5. doi: 10.1016/s0140-6736(85)91444-8.
Of 109 patients with cirrhosis and endoscopically demonstrated oesophageal varices who had not bled, 56 were treated by sclerotherapy and 53 were treated conservatively. Patients were assigned to one of three categories according to varix size and Child's classification of severity of liver disease. Severity of liver disease increased with varix size. Frequency of haemorrhage in the control group also increased with varix size: haemorrhage occurred from small varices in 35% of patients, from medium varices in 53%, and from large varices in 83%. Prophylactic sclerotherapy diminished the frequency of variceal bleeding and overall mortality: over 25 months, frequency of bleeding was 9% in the therapy group and 57% in the controls, with mortality rates of 23% and 55%, respectively.
109例经内镜证实有食管静脉曲张但未出血的肝硬化患者中,56例接受了硬化疗法,53例接受了保守治疗。根据静脉曲张大小和Child肝病严重程度分级,将患者分为三类。肝病严重程度随静脉曲张大小增加而加重。对照组出血频率也随静脉曲张大小增加而增加:小静脉曲张患者出血发生率为35%,中静脉曲张患者为53%,大静脉曲张患者为83%。预防性硬化疗法降低了静脉曲张出血频率和总体死亡率:在25个月的时间里,治疗组出血频率为9%,对照组为57%,死亡率分别为23%和55%。