新型球囊压迫辅助内镜下注射硬化治疗与内镜下食管静脉曲张套扎术治疗食管静脉曲张：一项前瞻性随机研究。

Novel balloon compression-assisted endoscopic injection sclerotherapy and endoscopic variceal ligation in the treatment of esophageal varices: a prospective randomized study.

机构信息

Department of Gastroenterology, Key Laboratory of Digestive Diseases of Anhui Province, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, China.

Fuyang Hospital of Anhui Medical University, Fuyang, Anhui, 236000, People's Republic of China.

出版信息

Surg Endosc. 2022 Oct;36(10):7839-7847. doi: 10.1007/s00464-022-09412-6. Epub 2022 Jul 25.

DOI:10.1007/s00464-022-09412-6

PMID:35879573

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9485182/

Abstract

BACKGROUND

Herein, our group designed a novel technology, termed balloon compression-assisted endoscopic injection sclerotherapy (bc-EIS), which was applied to improve the efficiency of eradicating esophageal varices (EVs). The present study aimed to compare the rate of eradication and efficacy between bc-EIS and endoscopic variceal ligation (EVL) in the management of EVs.

METHODS

Ninety-five patients with esophageal variceal bleeding (EVB) were randomly assigned to receive bc-EIS or ligation alone. Additional treatment sessions were held 1 month later and then at 3-month intervals until eradication of the varices was achieved. Endoscopic follow-up examinations were carried out at 6-month intervals in the absence of recurrence or immediately if there was any recurrent bleeding.

RESULTS

The mean physical injection points per session were 2.89 ± 0.79, and the mean volume of lauromacrogol used per session was 17.74 ± 7.09 ml in the bc-EIS group. The mean band per session was 6.13 ± 0.86. The rate of eradication after one to three rounds of bc-EIS was obviously higher than that of the EVL group (89.36%, 97.87%, and 100% vs. 37.5%, 43.75%, and 47.92%, respectively). Retrosternal pain or discomfort in the bc-EIS group was slightly lower than that in the EVL group (23.4%, 11/47 vs. 31.25%, 15/48). Two and five patients showed mild abdominal bloating and distension between the bc-EIS and EVL groups, respectively (2/47, 4.26% vs. 5/48, 10.42% P > 0.05). Nausea and vomiting were reported in one patient (1/47, 2.13%) in the bc-EIS group and three patients (3/48, 6.25%) in the EVL group. However, there were no statistically significant differences between the two groups (P > 0.05). No fatal or severe complications, such as esophageal perforation, esophageal stricture or ectopic embolism, were observed.

CONCLUSION

The bc-EIS method was effective in eradicating EVs and was accompanied by fewer complications.

摘要

背景

本研究组设计了一种新的技术，即球囊压迫辅助内镜下注射硬化治疗（bc-EIS），旨在提高消除食管静脉曲张（EVs）的效率。本研究旨在比较 bc-EIS 与内镜下套扎术（EVL）治疗 EVs 的根除率和疗效。

方法

95 例食管静脉曲张出血（EVB）患者随机分为 bc-EIS 组或结扎组。在 1 个月后和之后每 3 个月进行一次额外的治疗，直到静脉曲张消除。在没有复发的情况下，每 6 个月进行一次内镜随访检查，如果有任何复发出血则立即进行。

结果

bc-EIS 组每次治疗的物理注射点数为 2.89±0.79，每次使用的 lauromacrogol 体积为 17.74±7.09ml。每次治疗的套扎带数为 6.13±0.86。bc-EIS 组在 1-3 轮治疗后的根除率明显高于 EVL 组（分别为 89.36%、97.87%和 100%比 37.5%、43.75%和 47.92%）。bc-EIS 组胸骨后疼痛或不适的发生率略低于 EVL 组（23.4%，11/47 比 31.25%，15/48）。bc-EIS 组和 EVL 组分别有 2 例（2/47，4.26%）和 5 例（5/48，10.42%）患者出现轻度腹胀（P>0.05）。bc-EIS 组有 1 例（1/47，2.13%）和 EVL 组有 3 例（3/48，6.25%）患者出现恶心呕吐，但差异无统计学意义（P>0.05）。两组均无致命或严重并发症，如食管穿孔、食管狭窄或异位栓塞。