AIM: To compare n-butyl-2-cyanoacrylate, iso-amyl-2-cyanoacrylate and a mixture of 72% chromated glycerin with hypertonic glucose solution in management of gastric varices. METHODS: Ninety patients with gastric varice...AIM: To compare n-butyl-2-cyanoacrylate, iso-amyl-2-cyanoacrylate and a mixture of 72% chromated glycerin with hypertonic glucose solution in management of gastric varices. METHODS: Ninety patients with gastric varices presented to Endoscopy Unit of Ain Shams University Hospital were included. They were randomly allocated into three groups; each group included 30 patients treated with intravariceal sclerosant injections in biweekly sessions till complete obturation of gastric varices; Group I(n-butyl-2-cyanoacrylate; Histoacryl), Group II(iso-amyl-2-cyanoacrylate; Amcrylate) and Group III(mixture of 72% chromated glycerin; Scleremo with glucose solution 25%). All the procedures were performed electively without active bleeding. Recruited patients were followed up for 3 mo. RESULTS: 26% of Scleremo group had bleeding during puncture vs 3.3% in each of the other two groups with significant difference,(P < 0.05). None of Scleremo group had needle obstruction vs 13.3% in each of the other two groups with no significant difference,(P > 0.05). Rebleeding occurred in 13.3% of Histoacryl and Amcrylate groups vs 0% in Scleremo group with no significant difference. The in hospital mortality was 6.6% in both Histoacryl and Amcrylate groups, while it was 0% in Scleremo group with no significant difference. In the first and second sessions, the amount of Scleremo needed for obturation was significantly high, while the amount of Histoacryl was significantly low. Scleremo was the less costly of the two treatments. CONCLUSION: All used sclerosant substances showed efficacy and success in management of gastric varices with no significant differences except in total amount, cost and bleeding during puncture.展开更多
目的:总结各种心内、心外分流性疾病右心声学造影的不同表现,明确右心声学造影的临床价值。方法:回顾性分析我院2006-2014年期间行右心声学造影检查的102例受检者的超声表现。造影剂为9 ml 50%葡萄糖注射液与1ml空气混合形成的手振50...目的:总结各种心内、心外分流性疾病右心声学造影的不同表现,明确右心声学造影的临床价值。方法:回顾性分析我院2006-2014年期间行右心声学造影检查的102例受检者的超声表现。造影剂为9 ml 50%葡萄糖注射液与1ml空气混合形成的手振50%葡萄糖溶液。结果:检出分流性疾病49例,包括右向左或双向分流房间隔缺损8例、左向右分流房间隔缺损7例、卵圆孔未闭伴功能性右向左分流9例、动脉导管未闭合并肺动脉高压13例、肺动静脉瘘3例、永存左上腔静脉引流入冠状静脉窦8例、引流入左心房1例。结论:右心声学造影能够简便、有效地检出合并肺动脉高压患者心内、心外异常分流,提高先天性心脏病诊断的准确性,是一项重要且实用的辅助诊断方法。展开更多
文摘AIM: To compare n-butyl-2-cyanoacrylate, iso-amyl-2-cyanoacrylate and a mixture of 72% chromated glycerin with hypertonic glucose solution in management of gastric varices. METHODS: Ninety patients with gastric varices presented to Endoscopy Unit of Ain Shams University Hospital were included. They were randomly allocated into three groups; each group included 30 patients treated with intravariceal sclerosant injections in biweekly sessions till complete obturation of gastric varices; Group I(n-butyl-2-cyanoacrylate; Histoacryl), Group II(iso-amyl-2-cyanoacrylate; Amcrylate) and Group III(mixture of 72% chromated glycerin; Scleremo with glucose solution 25%). All the procedures were performed electively without active bleeding. Recruited patients were followed up for 3 mo. RESULTS: 26% of Scleremo group had bleeding during puncture vs 3.3% in each of the other two groups with significant difference,(P < 0.05). None of Scleremo group had needle obstruction vs 13.3% in each of the other two groups with no significant difference,(P > 0.05). Rebleeding occurred in 13.3% of Histoacryl and Amcrylate groups vs 0% in Scleremo group with no significant difference. The in hospital mortality was 6.6% in both Histoacryl and Amcrylate groups, while it was 0% in Scleremo group with no significant difference. In the first and second sessions, the amount of Scleremo needed for obturation was significantly high, while the amount of Histoacryl was significantly low. Scleremo was the less costly of the two treatments. CONCLUSION: All used sclerosant substances showed efficacy and success in management of gastric varices with no significant differences except in total amount, cost and bleeding during puncture.
文摘目的:总结各种心内、心外分流性疾病右心声学造影的不同表现,明确右心声学造影的临床价值。方法:回顾性分析我院2006-2014年期间行右心声学造影检查的102例受检者的超声表现。造影剂为9 ml 50%葡萄糖注射液与1ml空气混合形成的手振50%葡萄糖溶液。结果:检出分流性疾病49例,包括右向左或双向分流房间隔缺损8例、左向右分流房间隔缺损7例、卵圆孔未闭伴功能性右向左分流9例、动脉导管未闭合并肺动脉高压13例、肺动静脉瘘3例、永存左上腔静脉引流入冠状静脉窦8例、引流入左心房1例。结论:右心声学造影能够简便、有效地检出合并肺动脉高压患者心内、心外异常分流,提高先天性心脏病诊断的准确性,是一项重要且实用的辅助诊断方法。