Moretó M, Zaballa M, Ojembarrena E, Ibáñez S, Suárez M J, Setién F, Delgado E
Hepato-Gastroenterology Department, Hospital de Cruces, School of Medicine, Bilbao, Spain.
Gut. 1994 May;35(5):687-91. doi: 10.1136/gut.35.5.687.
Short term sclerotherapy (by injection(s) around the bleeding point) is used for immediate control of massive haemorrhage from oesophagogastric varices. The usefulness of longterm sclerotherapy once short term sclerotherapy has been successfully carried out was assessed. Two treatment groups were studied: 50 patients were treated by 'combined' (short term followed by longterm) sclerotherapy; 56 patients were treated by short term sclerotherapy only. Patients included in the second group were treated by short term sclerotherapy only if a variceal rebleeding was present. The overall cumulative proportion of patients rebleeding was not significantly different in either group. Combined sclerotherapy patients, however, experienced less episodes of variceal haemorrhage and the source of haemorrhage was different (p < 0.002). Combined sclerotherapy was more efficient in preventing bleeding from oesophageal bleeding points but not those arising from a junctional source (p < 0.05). A greater incidence of oesophageal rebleeding was found in those patients whose first source of bleeding was oesophageal (p < 0.05). No significant difference was detected in survival expectancy between either group. In conclusion, after short term sclerotherapy is carried out successfully, those patients with bleeding from variceal bleeding points located on oesophageal mucosa should benefit most from a longterm sclerotherapy programme.
短期硬化疗法（通过在出血点周围注射）用于立即控制食管胃静脉曲张引起的大量出血。在短期硬化疗法成功实施后，评估了长期硬化疗法的有效性。研究了两个治疗组：50例患者接受“联合”（短期后接长期）硬化疗法；56例患者仅接受短期硬化疗法。第二组中的患者仅在出现静脉曲张再出血时才接受短期硬化疗法。两组患者再出血的总体累积比例无显著差异。然而，联合硬化疗法的患者静脉曲张出血发作较少，且出血来源不同（p<0.002）。联合硬化疗法在预防食管出血点出血方面更有效，但对交界部位出血点无效（p<0.05）。首次出血来源为食管的患者食管再出血发生率更高（p<0.05）。两组患者的预期生存期无显著差异。总之，在短期硬化疗法成功实施后，那些食管黏膜上静脉曲张出血点出血的患者应从长期硬化疗法方案中获益最大。
