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[内镜下硬化治疗食管静脉曲张破裂出血。50例前瞻性研究结果]

[Endoscopic sclerosing for hemorrhage due to ruptured esophageal varices. Results of a prospective study of 50 cases].

作者信息

Gertsch P, Mosimann F, Loup P W, Mosimann R

出版信息

Schweiz Med Wochenschr. 1986 Apr 26;116(17):569-71.

PMID:3487113
Abstract

A prospective evaluation of sclerotherapy for bleeding esophageal varices has been conducted in 50 unselected consecutive patients. According to Child's classification, 36% were class A, 34% class B and 30% class C. Sclerotherapy was performed on an emergency basis in 22 patients and was delayed a few hours for the others. The aim of the technique was to obliterate the varices by intra- and paravariceal injections of polidocanol 1%. Injections were performed weekly for the first 3 weeks of treatment, then 3- or 6-monthly. Four patients had a severe recurrent hemorrhage during the first month. The mortality during that period was 12%. Follow-up was possible in 81% of the surviving patients. Four stenoses were treated by dilatation. Four patients had a late-recurring hemorrhage which was easily controlled in 3. Four patients died later, 3 of liver insufficiency and one of hemorrhage.

摘要

对50例未经挑选的连续性患者进行了硬化疗法治疗食管静脉曲张出血的前瞻性评估。根据Child分级,36%为A级,34%为B级,30%为C级。22例患者在紧急情况下接受了硬化疗法,其他患者推迟了数小时。该技术的目的是通过向曲张静脉内和曲张静脉旁注射1%的聚多卡醇来消除曲张静脉。治疗的前3周每周进行注射,然后每3个月或6个月注射一次。4例患者在第一个月出现严重复发性出血。该期间的死亡率为12%。81%的存活患者接受了随访。4例狭窄患者接受了扩张治疗。4例患者出现晚期复发性出血,其中3例出血易于控制。4例患者随后死亡,3例死于肝功能不全,1例死于出血。

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