Junquera F, Santos J, Saperas E, Armengol J R, Malagelada J R
Servicio de Aparato Digestivo, Hospital General Universitari Vall d'Hebron, Barcelona.
Gastroenterol Hepatol. 1995 Feb;18(2):61-5.
The efficacy of an association of estrogens and progestagens in the treatment of gastrointestinal bleeding by angiodysplasia was analyzed. Thirty-three patients with gastrointestinal bleeding due to vascular malformations were admitted from January 1986 to December 1993. Fifteen of the 33 patients were submitted to surgical or endoscopic treatment. The remaining 18 patients underwent daily oral treatment with a combination of estrogens-progestagens containing 2.5 mg of lynestrenol and 0.075 mg of mestranol. One patient presented a venous thrombosis leading to suppression of treatment at one month of initiation. The 17 remaining patients were treated for a mean of 22 +/- 4 months (range: 3-60). During treatment 13 of the 17 patients (76%) did not present evidence of hemorrhage. Likewise, the number of hemorrhagic episodes per year decreased from 4.4 +/- 1.2 prior to treatment to 0.7 +/- 0.5 during treatment (p < 0.05) with transfusional requirements decreasing from 7.9 +/- 2.8 erythrocyte concentrates per year prior to treatment to 1.2 +/- 1.0 during treatment (p < 0.05). In conclusion, the combined treatment with estrogens and progestagens prevents recurrence of gastrointestinal bleeding by angiodysplasia.
分析了雌激素与孕激素联合治疗血管发育异常所致胃肠道出血的疗效。1986年1月至1993年12月收治了33例因血管畸形导致胃肠道出血的患者。33例患者中有15例接受了手术或内镜治疗。其余18例患者每日口服含2.5mg炔诺酮和0.075mg炔雌醇甲醚的雌激素 - 孕激素组合药物。1例患者在开始治疗1个月时出现静脉血栓形成，导致治疗中断。其余17例患者平均治疗22±4个月（范围：3 - 60个月）。治疗期间，17例患者中有13例（76%）未出现出血迹象。同样，每年出血发作次数从治疗前的4.4±1.2次降至治疗期间的0.7±0.5次（p<0.05），输血需求量从治疗前每年7.9±2.8单位红细胞浓缩液降至治疗期间的1.2±1.0单位（p<0.05）。总之，雌激素与孕激素联合治疗可预防血管发育异常所致胃肠道出血的复发。
