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食管静脉曲张出血是肝硬化门脉高压患者的主要死亡原因。七十年代初的研究表明,减压分流术能有效地减少出血发生率,但术后严重脑病、肝功能衰竭和死亡率增加。内镜下食管静脉曲张硬化治疗为预防静脉曲张出血的另一种手段,其侵入性小,可避免手术后并发症。病人和方法:1980年2月至1988年10月,皇家Hallamshire医院将组织学证实为肝硬化,并符合以下条件的患者选入研究:(1)内镜下有可作腔内注射的食管静脉曲张;(2)以前无静脉曲张出血史;(3)年龄18～70岁;(4)HBsAg阴性;(5)未用β阻滞剂。先给受试者作肝静脉楔入压梯度(WHVPG)测定,如WHVPG<12mmHg为非随机组,定期随访;如WHVPG≥12mmHg,随机分为注射和非注射组。在注射组,将5％氨基乙醇(ethanolamine)注入其曲张静脉腔内。以后,每隔3周重复注射一次,直至曲张静脉血栓形成。于3～6个月内镜复查并再予恰当的注射。最初的血栓形成平均需要注射2.8次(1～5次)。随访14～107个月,中位值61个月。
Esophageal variceal bleeding is the leading cause of death in cirrhotic patients with portal hypertension. Research in the early seventies shows that decompression shunt can effectively reduce the incidence of bleeding, but severe encephalopathy, increased liver failure and mortality after surgery. Endoscopic esophageal varicosis sclerotherapy for the prevention of variceal bleeding another means of its small invasive, to avoid postoperative complications. PATIENTS AND METHODS: From February 1980 to October 1988, the Royal Hallamshire Hospital histologically identified patients with cirrhosis who met the following criteria for inclusion in the study: (1) endoscopic esophageal veins for endovascular injection Varicose veins; (2) previous history of variceal bleeding; (3) age of 18 to 70 years; (4) HBsAg negative; (5) without beta blockers. The subjects were given hepatic venous wedge pressure gradient (WHVPG) determination, such as WHVPG <12mmHg non-randomized group, regular follow-up; such as WHVPG ≥ 12mmHg, were randomly divided into injection and non-injection group. In the injection group, 5% ethanolamine was injected into the varicose veins. Later, repeat injections every 3 weeks until varicose vein thrombosis. Endoscopy in 3 to 6 months and then give the appropriate injection. The initial thrombosis requires an average of 2.8 injections (1 to 5). Follow-up 14 to 107 months, median 61 months.