食管静脉曲张破裂出血应用硬化剂治疗的远期疗效

LONG-TERM EFFECTS OF ENDOSCOPIC SCLEROTHERAPY FOR ESOPHAGEAL VARICEAL RUPTURE BLEEDING

观察用硬化剂治疗食管静脉曲张破裂出血的远期疗效。用硬化剂（乙氧硬化醇）注射治疗３６例食管静脉曲张破裂出血病人，作静脉旁及静脉内联合注射，直至曲张静脉消失或基本消失，平均随访７ａ，观察其再出率及生存率，并与同期内科常规治疗的３３例食管静脉曲张破裂出血病人作对比分析（采用Ｘ２检验及Ｆｉｓｈｅｒ＇ｓ精确概率法）。结果：硬化剂治疗组与内科常规治疗组的５ａ生存率分别为７１．４％与２７．３％（Ｐ＜０．０１），１０ａ生存率分别为４１．７％与１２．１％（Ｐ＜０．０１），再出血率分别为２７．８％与７５．７％（Ｐ＜０．０１）。结论：硬化剂治疗能有效地降低再出血率，延长生存期，其远期疗效是满意的。用硬化剂对食管静脉曲张的根治及随之产生的肝功能改善是成功地延长生存期，降低再出血率的关键。

PURPOSE To evaluate the longterm effects of sclerotherapy, tow groups of the patients were followed up.METHODS 36 patients with esophageal variceal rupture bleeding were selected for sclerotherapy by paravariceally and intravariceally injection of 1% aethoxysklerol until the varics eliminated or almost eliminated.The recurrent and survival rate were obsered for a mean of 7 years's following up,At the same time,we observed 33 cases of esophageal variceal rupture bleeding patients with medical routine therapy. Then we analysed and compared the results with X2 test and Fisher's exact test.RESULTS The 5-year survival rate were 71.4%in the sclerotherapy group and 27.3% in control group(P<0.01).10-year survival rate were 41.7%,12.1% respectively(P<0.01)Rebleeding rates were 27.8%in the former and 75.7%in the latter(P<0.01).CONCLUSIONS The sclerotherapy can decrese rebleeding rate and improve the survival in esophageal variceal rupture bleeding patient.These satisfactory effects of the therapy may be related to eradication of esophageal varices and improving in liver function.