胃静脈瘤出血に対する緊急内視鏡的硬化療法 : とくにHistoacryl法の手技と臨床的有用性について

概要

論文の詳細を見る
Endoscopic injection sclerotherapy (EIS) using Histoacryl as the sclerosing agent, was performed on 21 patients with gastric variceal bleeding since May 1989. We report the method and the device used in our EIS procedure, to treat patients with gastric variceal bleeding in emergency situations. We compared the results of this procedure, with those obtained by EIS using 5% ethanolamine oleate (EO) as the sclerosing agent. The success rate of complete hemostasis using Histoacryl was 95.2%, as compared to 52.4% with the procedure in which 5% EO was used. The new procedure not only gave a higher overall success rate, but also reduced the frequency of re-bleeding. The percentage of patients who required post-EIS surgery after treatment with 5% EO, was 42.8%, while none of the patients treated with Histoacryl required post EIS surgery. The overall accumulative survival rate was significantly higher in the patients who received the Histoacryl method, than in those who received the 5% EO method. No patient died from re-bleeding after treatment with the Histoacryl method. Thus, the Histoacryl method eliminated not only death from hemorrhage, but also post-EIS surgery. The purpose of emergency EIS for gastric variceal bleeding, is to prevent death from hemorrhage. The Histoacryl method seems to be the most useful procedure in achieving this goal.
東京女子医科大学の論文
1998-12-25