Koyama T, Fujimoto K, Iwakiri R, Sakata H, Sakata Y, Yamaoka K, Yamaguchi M, Sakai T, Hisatsugu T
Department of Internal Medicine, Saga Medical School, Japan.
Gastrointest Endosc. 1995 Aug;42(2):128-31. doi: 10.1016/s0016-5107(95)70068-4.
We performed a prospective, randomized trial to assess the efficacy of endoscopic injection therapy with absolute ethanol in preventing recurrent bleeding in patients with nonbleeding visible vessels in gastric ulcers. During the period of 1990 to 1993, 62 patients who bled were found to have gastric ulcers with nonbleeding visible vessels; all of them were enrolled for this trial. The 62 patients were randomly divided into two groups, which were comparable at entry. In group I (33 patients), we performed endoscopic injection therapy with absolute ethanol. In group II (29 patients), we sprayed the ulcers with 0.1% epinephrine and thrombin. Endoscopic injection therapy with ethanol was performed at the second endoscopy in the patients in both groups who had recurrent bleeding. Among the 33 patients in group I, 4 patients (12.1%) rebled after the initial ethanol injection therapy, whereas 10 of 29 patients (34.5%) rebled in the control group (p < .05). No patients in group I required surgical intervention, and ultimate hemostasis was achieved in all 33 group I patients (100%), indicating that endoscopic ethanol injection therapy achieves ultimate hemostasis and prevents recurrent bleeding in patients with gastric ulcers and nonbleeding visible vessels.
我们进行了一项前瞻性随机试验，以评估用无水乙醇进行内镜注射治疗在预防胃溃疡无出血可见血管患者复发性出血方面的疗效。在1990年至1993年期间，发现62例出血患者患有伴有无出血可见血管的胃溃疡；他们全部入选本试验。62例患者被随机分为两组，两组在入组时具有可比性。第一组（33例患者），我们用无水乙醇进行内镜注射治疗。第二组（29例患者），我们用0.1%肾上腺素和凝血酶喷洒溃疡。两组中出现复发性出血的患者在第二次内镜检查时进行乙醇内镜注射治疗。第一组的33例患者中，4例（12.1%）在初次乙醇注射治疗后再次出血，而对照组29例患者中有10例（34.5%）再次出血（p<0.05）。第一组中没有患者需要手术干预，第一组的所有33例患者（100%）最终实现止血，表明内镜乙醇注射治疗可实现最终止血，并预防胃溃疡无出血可见血管患者的复发性出血。
