Fleig W E, Stange E F, Ruettenauer K, Ditschuneit H
Gastrointest Endosc. 1983 Feb;29(1):8-14. doi: 10.1016/s0016-5107(83)72489-2.
To assess the efficacy of endoscopic paravariceal sclerotherapy (EPS) compared to balloon tamponade, 25 patients with massive hemorrhage from esophageal varices not responding to Sengstaken or Linton tube tamponade were treated by emergency EPS. None of the patients had received vasopressin. Immediate control of hemorrhage was achieved in 92%. Recurrent bleeding occurred in 17.4% of patients during their primary admission. Minor complications resulting from EPS were observed in three patients (12%): esophageal ulcer, esophageal stenosis, and pleural effusion. Ten patients (40%) died in the hospital, seven of them despite arrested hemorrhage. Fifteen patients were discharged and followed at 3-month intervals for a mean of 21.3 months (range, 8.8 to 29.7). During this period one death due to liver failure without recurrent hemorrhage and three rebleeding events in two patients were observed (rebleeding risk per patient month, 9.4 x 10(-3). We conclude that EPS is very effective in controlling acute bleeding from esophageal varices, even in poor risk patients with ineffective balloon tamponade.
为评估内镜下曲张静脉旁硬化疗法（EPS）与气囊压迫相比的疗效，对25例食管静脉曲张大出血且对Sengstaken或Linton管压迫治疗无效的患者进行了急诊EPS治疗。所有患者均未接受过血管加压素治疗。92%的患者出血得到立即控制。17.4%的患者在首次住院期间出现再出血。3例患者（12%）出现了EPS引起的轻微并发症：食管溃疡、食管狭窄和胸腔积液。10例患者（40%）在医院死亡，其中7例尽管出血已停止。15例患者出院，每隔3个月随访一次，平均随访21.3个月（范围8.8至29.7个月）。在此期间，观察到1例因肝功能衰竭死亡且无再出血，2例患者发生3次再出血事件（每位患者每月再出血风险为9.4×10⁻³）。我们得出结论，即使在气囊压迫无效的高危患者中，EPS在控制食管静脉曲张急性出血方面也非常有效。
