Moretó M, Zaballa M, Bernal A, Ibáñez S, Ojembarrena E, Rodriguez A
Digestive Endoscopy Unit, Hospital de Cruces, School of Medicine, Bilbao, Spain.
Surg Gynecol Obstet. 1988 Oct;167(4):331-4.
Sengstaken-Blakemore tamponade is used for the initial control of bleeding esophageal varices (BEV), although it is known to be potentially dangerous. Sclerotherapy has been shown to be effective in the treatment of BEV. This trial has been designed to evaluate comparatively the effectiveness of both procedures in the initial control of the hemorrhage. Forty-three patients with BEV were included in the trial. Twenty patients (group SB) were treated by tamponade. Twenty-three patients (group ST) were treated by sclerotherapy by means of a simple technique. During the first 24 hours, hemostasis was obtained in 16 of the SB patients and in all 23 of the ST patients (p less than 0.05). At seven days, nine SB patients and 19 ST patients were free of hemorrhagic relapse (p less than 0.05). By stratifying in relation to hepatic failure, the difference was greater (p less than 0.005) if patients with Child's A classification were excluded. It is concluded that sclerotherapy should be undertaken in almost every instance at the same moment that diagnosis is made, bypassing the intermediate step of tamponade.
三腔二囊管压迫止血法用于食管静脉曲张破裂出血（BEV）的初步控制，尽管已知其有潜在危险。硬化疗法已被证明对BEV治疗有效。本试验旨在比较这两种方法在初步控制出血方面的有效性。43例BEV患者纳入试验。20例患者（SB组）采用压迫止血法治疗。23例患者（ST组）采用一种简单技术进行硬化疗法治疗。在最初24小时内，SB组16例患者止血，ST组23例患者全部止血（p<0.05）。7天时，9例SB组患者和19例ST组患者无出血复发（p<0.05）。按肝功能衰竭分层，如果排除Child A级分类的患者，差异更大（p<0.005）。结论是，几乎在每一例诊断时都应进行硬化疗法，而绕过压迫止血这一中间步骤。
