Feretis C, Dimopoulos C, Benakis P, Kalliakmanis B, Apostolidis N
Department of Surgical Endoscopy, Hygeia Diagnostic and Therapeutic Center, Athens, Greece.
Endoscopy. 1995 Jun;27(5):355-7. doi: 10.1055/s-2007-1005713.
N-2-cyanoacrylate (Histoacryl) and endoscopic sclerotherapy with polidocanol have both been reported to control variceal bleeding. The aim of the present study was to compare the effectiveness of the combination of Histoacryl and endoscopic sclerotherapy with polidocanol in the management of these patients regarding early rebleeding and hospital mortality rates.
One hundred twenty-six consecutive patients with variceal hemorrhage treated with injection therapy between March 1990 and July 1993 were included in this randomized prospective study. Sixty-seven patients (Group A) were treated with Histoacryl and conventional sclerotherapy with polidocanol, and 59 patients (Group B) were treated with conventional sclerotherapy with polidocanol alone. Histoacryl was injected intravariceally during the first session in the Group A patients.
A significantly lower bleeding recurrence rate was found in Group A patients who presented with active bleeding at the first treatment session (Group A: 2 of 20, Group B: 8 of 18, p < 0.05). The hospital mortality was also significantly lower in these patients (Group A: 3 of 21, Group B: 9 of 18, p < 0.05).
The combination of Histoacryl with conventional sclerotherapy with polidocanol in patients with esophageal bleeding who present with active bleeding, at the initial injection therapy, can improve the results of endoscopic management.
据报道，N-2-氰基丙烯酸酯（组织黏合剂）和聚多卡醇内镜下硬化治疗均可控制静脉曲张出血。本研究旨在比较组织黏合剂与聚多卡醇内镜下硬化治疗联合应用在这些患者早期再出血和医院死亡率方面的疗效。
本随机前瞻性研究纳入了1990年3月至1993年7月间连续接受注射治疗的126例静脉曲张出血患者。67例患者（A组）接受组织黏合剂和聚多卡醇传统硬化治疗，59例患者（B组）仅接受聚多卡醇传统硬化治疗。A组患者在首次治疗时将组织黏合剂注入曲张静脉内。
首次治疗时出现活动性出血的A组患者出血复发率显著较低（A组：20例中有2例，B组：18例中有8例，p<0.05）。这些患者的医院死亡率也显著较低（A组：21例中有3例，B组：18例中有9例，p<0.05）。
对于初次注射治疗时出现活动性出血的食管出血患者，组织黏合剂与聚多卡醇传统硬化治疗联合应用可改善内镜治疗效果。
