Kitano S, Iso Y, Koyanagi N, Higashi H, Sugimachi K
Hepatogastroenterology. 1987 Feb;34(1):19-23.
Thirty-four consecutive patients with liver cirrhosis and esophageal varices were included in a prospective randomized trial done to investigate the efficacy and safety of two sclerosants 5% ethanolamine oleate (EO) and polidocanol (1% Aethoxysklerol [AS]) for use in endoscopic injection sclerotherapy (EIS). Eighteen patients were randomly allocated to the group given EO and 16 to the AS group. These two groups were comparable with regard to age, sex, etiology and severity of the liver disease. The bleeding rate from esophageal ulcers which developed during the course of repeated EIS was significantly (P less than 0.05) higher in the AS group (31.3%, 5/16) than in the EO group (0%, 0/18). In 4 occasions bleeding from the esophageal ulcer could not be controlled with AS. In 3 of these 4 bleeding episodes, EO successfully halted bleeding from esophageal ulcer. In the other patient, a Sengstaken-Blakemore tube was inserted to stop the hemorrhage. The period and number of sessions of EIS for eradication of esophageal varices were significantly (P less than 0.05) shorter in the EO group than the AS group (EO: 4.0 +/- 0.8 [means +/- SD] sessions during 4.7 +/- 1.5 weeks versus AS: 4.8 +/- 1.2 sessions during 5.4 +/- 1.6 weeks). The rate of early mortality did not differ between the two groups. We conclude that 5% ethanolamine oleate seems to be superior to 1% Aethoxysklerol when used for sclerosing esophageal varices.
34例肝硬化合并食管静脉曲张患者被纳入一项前瞻性随机试验,以研究两种硬化剂5%油酸乙醇胺(EO)和聚多卡醇(1%乙氧硬化醇[AS])用于内镜注射硬化治疗(EIS)的有效性和安全性。18例患者被随机分配至接受EO治疗的组,16例被分配至AS组。这两组在年龄、性别、肝病病因和严重程度方面具有可比性。在重复EIS过程中发生的食管溃疡出血率,AS组(31.3%,5/16)显著高于EO组(0%,0/18)(P<0.05)。有4次食管溃疡出血用AS无法控制。在这4次出血事件中的3次,EO成功止住了食管溃疡出血。在另1例患者中,插入了Sengstaken-Blakemore管以止血。EO组根除食管静脉曲张的EIS疗程和次数显著少于AS组(P<0.05)(EO组:在4.7±1.5周内进行4.0±0.8次[均值±标准差]疗程,而AS组:在5.4±1.6周内进行4.8±1.2次疗程)。两组的早期死亡率无差异。我们得出结论,5%油酸乙醇胺用于硬化食管静脉曲张时似乎优于1%乙氧硬化醇。