Miyazaki S, Yoshida T, Harada T, Shigemitsu T, Takeo Y, Okita K
First Department of Internal Medicine, Yamaguchi University, Ube-City, Japan.
Hepatogastroenterology. 1998 Jul-Aug;45(22):1155-8.
BACKGROUND/AIMS: Tissue adhesive agents, such as the cyanoacrylates, have been used as an alternative to conventional sclerotherapy to treat gastric varices, but the long-term efficacy of this approach has not been determined. We evaluated the efficacy and long-term outcome of injection sclerotherapy with n-butyl-2-cyanoacrylate and ethanolamine oleate in 16 patients with gastric varices.
We evaluated the effect of injection sclerotherapy in 16 Japanese patients with gastric varices. Injection sclerotherapy was performed on an emergency basis in 6 patients, an elective basis in 5 patients, and as prophylaxis in 5 patients.
No bleeding was observed in the 7 patients in whom gastric varices disappeared during the 51 month follow-up period. The non-bleeding rate after treatment was significantly higher in this group than in the 9 patients in whom gastric varices did not disappear (p<0.05). Acute bleeding was stopped in 5 (83.3%) of 6 patients. The single failure was a patient in whom the sclerosant could not be injected into the gastric varices. No serious complications, such as emboli in other organs, were observed.
The results suggest that this therapy is a safe and useful treatment for gastric varices and that the goal of injection sclerotherapy should be the disappearance of gastric varices.
背景/目的：组织粘合剂，如氰基丙烯酸酯，已被用作传统硬化疗法的替代方法来治疗胃静脉曲张，但这种方法的长期疗效尚未确定。我们评估了用正丁基-2-氰基丙烯酸酯和油酸乙醇胺对16例胃静脉曲张患者进行注射硬化疗法的疗效和长期结果。
我们评估了对16例日本胃静脉曲张患者进行注射硬化疗法的效果。6例患者在紧急情况下接受注射硬化疗法，5例患者在择期情况下接受治疗，5例患者作为预防措施接受治疗。
在51个月的随访期内，7例胃静脉曲张消失的患者未出现出血情况。该组治疗后的无出血率显著高于9例胃静脉曲张未消失的患者（p<0.05）。6例患者中有5例（83.3%）急性出血得到控制。唯一的失败病例是一名无法将硬化剂注入胃静脉曲张的患者。未观察到严重并发症，如其他器官的栓塞。
结果表明，这种疗法是治疗胃静脉曲张的一种安全有效的方法，注射硬化疗法的目标应该是胃静脉曲张消失。
