医学
氰基丙烯酸酯
胃静脉曲张
结扎
静脉曲张
外科
随机对照试验
瓦利克斯
B组
胃肠病学
内科学
肝硬化
胶粘剂
有机化学
化学
图层(电子)
作者
Gin‐Ho Lo,Kwok-Hung Lai,Jin-Shiung Cheng,Mei‐Hsiu Chen,Hung‐Ting Chiang
出处
期刊:Hepatology
[Wiley]
日期:2001-05-01
卷期号:33 (5): 1060-1064
被引量:464
标识
DOI:10.1053/jhep.2001.24116
摘要
Gastric variceal bleeding is a catastrophic event. Both cyanoacrylate injection and banding ligation have been proven to be effective in the management of bleeding gastric varices. This study was performed to compare the efficacy and complications of both the modalities. Cirrhotic patients with a history of gastric variceal bleeding were randomized to 2 groups. The group receiving endoscopic obturation (group A) comprised 31 patients and the group receiving band ligation (group B) comprised 29 patients. Butyl cyanoacrylate and pneumatic-driven ligator were applied, respectively. Treatment was repeated regularly until obliteration of gastric varices. Active bleeding occurred in 15 patients in group A and 11 patients in group B. Initial hemostatic rate (defined as no bleeding for 72 hours after treatment) was 87% in group A and 45% in group B (P = .03). The sessions required to achieve variceal obliteration and obliteration rates were similar in both the groups. However, rebleeding rates were significantly higher in group B (54%) than group A (31%) (P = .0005). Treatment-induced ulcer bleeding occurred in 2 patients (7%) in group A and 8 patients (28%) in group B (P = .03). The amount of blood transfusions required were also higher in group B than group A (4.2 ± 1.3 vs. 2.6 ± 0.9 units, respectively) (P < .01). Nine patients of group A and 14 patients of group B died (P = .05). In conclusion, endoscopic obturation using cyanoacrylate proved more effective and safer than band ligation in the management of bleeding gastric varices.
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