食管静脉曲张治疗:内镜下硬化和EUS引导下硬化治疗食管侧支静脉的随机对照研究

查看全文 作　　者：Andrade De Paulo [1]G.;Ardengh J. [2]C.;Nakao F. [2]S.;Ferrari [2]A.P.;陈瑜(译)[2];郑世成(校)[2] 机构地区：[1]Av. Dr. Altino Arantes 835/104, Sao Paulo, SP 04042-034, Brazil;[2]不详 出　　处：《世界核心医学期刊文摘(胃肠病学分册)》索引2006年第2卷第8期,共1页 摘　　要：Background: Endoscopic sclerotherapy (ES) and band ligation are standard treatments for esophageal varices. Unfortunately, recurrence is common and seems to be related to esophageal collateral vessels, easily identified by EUS. Eradication of these vessels might lead to a more durable therapeutic effect. Objective: To compare ES with EUS-guided sclerotherapy of collateral vessels (EUS-ES). Design: Randomized controlled trial. Setting: Endoscopy Unit, Division of Gastroenterology. Universidade Federal de S o Paulo, S o Paulo, Brazil. Patients and Interventions: Fifty cirrhotic patientswith esophageal varices were randomized into 2 groups: ES (n = 25) and EUS-ES (n = 25). EUS-ES was targeted at collateral veins. Patients were followed-up for at least 6 months after eradication. Main Outcome Measurements: Efficacy in eradication, complications, and recurrence of varices. Results: Varices were eradicated in 48 patients who adhered to the study protocol. The mean (SD) number of sessions until eradication was 4.3 (1.5) for the ES group and 4.1 (1.2) for the EUS-ES group. In ES group, 4 patients had mild bleeding. In EUS-ES group, 4 patients had pain. The mean (SD) length of the follow-up period was 22.6 (6.9) months for the ES group and 24.9 (8.1) months for the EUS-ES group. Recurrence was seen in 4 patients after ES and in 2 after EUS-ES (P = .32). The presence of collateral vessels was associated with recurrence (P = .003). Conclusion: EUS-ES is as safe and effective as ES in variceal eradication. Recurrence tends to be less frequent and occurs later. Persistence of esophageal collateral vessels after sclerotherapy is a risk factor for recurrence. 关 键 词：食管静脉曲张 随机对照研究 食管侧支 内镜下硬化 硬化治疗 EUS 引导 肝硬化患者 随机对照试验 随访时间