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内镜下食管静脉曲张结扎术与内镜下硬化治疗所致溃疡的比较及特征分析

Comparison and characterization of ulcerations induced by endoscopic ligation of esophageal varices versus endoscopic sclerotherapy.

作者信息

Young M F, Sanowski R A, Rasche R

机构信息

Carl T. Hayden Veterans Affairs Medical Center, Phoenix, AZ 85012.

出版信息

Gastrointest Endosc. 1993 Mar-Apr;39(2):119-22. doi: 10.1016/s0016-5107(93)70049-8.

Abstract

Esophageal variceal ligation and esophageal variceal sclerotherapy are two modes of therapy commonly used in the treatment of esophageal varices. The purpose of this study was to compare the local complications of these procedures, with special emphasis on production and healing of ulcerations. Twenty-three patients entered the study. Ten patients were randomized to esophageal variceal ligation and 13 to esophageal variceal sclerotherapy. Esophageal variceal ligation produced shallow (0.6 +/- 0.07 mm) circular ulcerations with a large surface area (85.4 +/- 20.3 mm2) that resolved in 14.4 +/- 1.4 days. Esophageal variceal sclerotherapy produced linear, deep ulcerations (1.8 +/- 0.01 mm) with a smaller surface area (13.3 +/- 2.8 mm2) and resolution in 20.9 +/- 1.3 days. These differences were statistically significant by independent t test (p < 0.0001). Esophageal variceal ligation patients required 3.6 +/- 0.4 sessions to achieve obliteration, whereas esophageal variceal sclerotherapy patients required 6.2 +/- 0.5 sessions (independent t test, p < 0.0001). No significant difference was noted between the two groups with regard to death or stricture formation.

摘要

食管静脉曲张结扎术和食管静脉曲张硬化疗法是治疗食管静脉曲张常用的两种治疗方式。本研究的目的是比较这些手术的局部并发症,特别着重于溃疡的产生和愈合情况。23名患者进入该研究。10名患者被随机分配接受食管静脉曲张结扎术,13名接受食管静脉曲张硬化疗法。食管静脉曲张结扎术产生的是浅的(0.6±0.07毫米)圆形溃疡,表面积大(85.4±20.3平方毫米),在14.4±1.4天内愈合。食管静脉曲张硬化疗法产生的是线性的、深的溃疡(1.8±0.01毫米),表面积较小(13.3±2.8平方毫米),在20.9±1.3天内愈合。通过独立t检验,这些差异具有统计学意义(p<0.0001)。食管静脉曲张结扎术患者需要3.6±0.4次治疗来实现闭塞,而食管静脉曲张硬化疗法患者需要6.2±0.5次治疗(独立t检验,p<0.0001)。两组在死亡或狭窄形成方面未观察到显著差异。

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