Snady H, Korsten M A, Waye J D
Gastrointest Endosc. 1985 Aug;31(4):243-6. doi: 10.1016/s0016-5107(85)72172-4.
The authors evaluated whether depth of needle insertion as determined by needle length is an important factor in sclerotherapy-associated bacteremia. In 18 consecutive sclerotherapy sessions in which sodium morrhuate was used, blood cultures were positive in 11% when using an injector with only 3 to 4 mm of needle protruding beyond the sheath, compared with the 39% incidence of bacteremia previously observed when an injector was used which permitted 6 to 8 mm of needle to protrude (0.01 less than p less than 0.05). Twenty-five additional sclerotherapy sessions in which the shorter needle was used were performed with a different sclerosant, 1% sodium tetradecyl sulfate; only 8% of blood cultures were positive. No correlation was found between fever and bacteremia. The authors conclude that the exposed needle length of the injector must be specified in any report of endoscopic variceal sclerotherapy with the flexible endoscope since this length is critical in the incidence of associated bacteremia and possibly other complications.
作者评估了根据针长度确定的进针深度是否是硬化治疗相关菌血症的一个重要因素。在连续18次使用鱼肝油酸钠的硬化治疗过程中，当使用针突出鞘外仅3至4毫米的注射器时，血培养阳性率为11%，而此前使用允许针突出6至8毫米的注射器时观察到的菌血症发生率为39%（P小于0.05且大于0.01）。另外25次使用较短针的硬化治疗过程使用了不同的硬化剂，即1%十四烷基硫酸钠；血培养阳性率仅为8%。未发现发热与菌血症之间存在相关性。作者得出结论，在任何关于使用软性内镜进行内镜下静脉曲张硬化治疗的报告中，必须指明注射器的外露针长度，因为该长度对于相关菌血症及可能的其他并发症的发生率至关重要。
