Kitano S, Iso Y, Yamaga H, Hashizume M, Higashi H, Sugimachi K
Department of Surgery II, Kyushu University Faculty of Medicine, Fukuoka, Japan.
Br J Surg. 1988 Aug;75(8):751-3. doi: 10.1002/bjs.1800750810.
Forty-five cirrhotic patients with oesophageal varices underwent endoscopic injection sclerotherapy in a prospective randomized trial carried out to compare two sclerosing agents (5 per cent ethanolamine oleate and 2 per cent sodium tetradecyl sulphate (STD] with respect to safety, efficacy and complications. Twenty-three patients were allocated to the ethanolamine group and twenty-two to the STD group. The rate of control of acute bleeding was 100 per cent (6/6) in the ethanolamine group and 75 per cent (3/4) in the STD group. There was a significantly lower rate of postinjection bleeding after the over-tube was removed at the initial session of sclerotherapy when ethanolamine was injected 0/23 versus 7/22, 32 per cent; P less than 0.01) and at the second session there was a significantly (P less than 0.01) higher rate of jet-like bleeding from injection sites in the STD group (6/21, 29 per cent) than in the ethanolamine group (0/22). The disappearance rate of red colour signs 1 week after the initial session of sclerotherapy in the ethanolamine group was 100 per cent and 62 per cent in the STD group. Early oesophageal ulcers developed less frequently in the ethanolamine group (0 and 9 per cent) than in the STD group (24 per cent and 43 per cent both after the initial (P less than 0.05) and the second session of sclerotherapy (P less than 0.01]. Early bleeding from an oesophageal ulcer occurred only in the STD group (5/21, 24 per cent) before the third session of sclerotherapy (P less than 0.05). The rate of early mortality did not differ between the two groups. We conclude that ethanolamine seems to be safer and more efficacious than STD for sclerosing oesophageal varices.
在一项前瞻性随机试验中，45例患有食管静脉曲张的肝硬化患者接受了内镜注射硬化疗法，该试验旨在比较两种硬化剂（5%油酸乙醇胺和2%十四烷基硫酸钠（STD））在安全性、有效性和并发症方面的差异。23例患者被分配到乙醇胺组，22例被分配到STD组。乙醇胺组急性出血的控制率为100%（6/6），STD组为75%（3/4）。在硬化疗法首次治疗时拔出外套管后，注射乙醇胺后的注射后出血率显著较低（0/23对比7/22，32%；P<0.01），在第二次治疗时，STD组注射部位喷射状出血率（6/21，29%）显著高于乙醇胺组（0/22）（P<0.01）。硬化疗法首次治疗1周后，乙醇胺组红色征消失率为100%，STD组为62%。乙醇胺组早期食管溃疡的发生率低于STD组（首次治疗后分别为0和9%，STD组为24%；第二次治疗后乙醇胺组为0和9%，STD组为43%，P<0.05和P<0.01）。食管溃疡早期出血仅发生在STD组（5/21，24%），在第三次硬化疗法前（P<0.05）。两组早期死亡率无差异。我们得出结论，在硬化食管静脉曲张方面，乙醇胺似乎比STD更安全、更有效。
