BACKGROUND:The outcome of sclerotherapy for bleeding oesophageal varices may be influenced by injection technique. In a previous study at our institution, sclerotherapy was associated with a high re-bleeding rate and oesophageal ulceration. Embolisation of the injection tract was introduced in an attempt to reduce injection-related complications. METHODS:To determine the outcome and effectiveness of injection tract embolisation in reducing injection-related complications, we retrospectively reviewed a series of 59 children who underwent injection sclerotherapy for oesophageal varices (29 for extrahepatic portal vein obstruction (EHPVO) and 30 for intrahepatic disease) in our centre. RESULTS:Sclerotherapy resulted in variceal eradication in only 11.8% of the children (mean follow-up duration: 38.4 months). Variceal eradication with sclerotherapy alone was achieved in 20.7% and 3.3% of EHPVO and intrahepatic disease patients, respectively. Injection tract embolisation was successful in reducing the number of complications and re-bleeding rates. Complications that arose included: transient pyrexia (16.7%); deep oesophageal ulcers (6.7%); stricture formation (3.3%); and re-bleeding before variceal sclerosis (23%). CONCLUSION:Injection sclerotherapy did not eradicate oesophageal varices in most children. Injection tract embolisation by sclerosant was associated with fewer complications and reduced re-bleeding rates.

译文

背景:硬化治疗食管静脉曲张破裂出血的结果可能受到注射技术的影响。在我们机构的先前研究中,硬化疗法与高再出血率和食道溃疡相关。为了减少与注射相关的并发症,引入了栓塞栓塞术。
方法:为了确定注射栓塞栓塞术在减少注射相关并发症方面的效果和有效性,我们回顾性分析了59例接受食管静脉曲张注射硬化治疗的儿童(29例肝外门静脉阻塞(EHPVO)和30例肝内疾病)在我们的中心。
结果:硬化疗法仅导致11.8%的儿童根除静脉曲张(平均随访时间:38.4个月)。仅EHPVO和肝内疾病患者分别采用硬化疗法根除静脉曲张。注射道栓塞术成功减少了并发症的数量和再出血率。引起的并发症包括:短暂性发热(16.7%);深食道溃疡(6.7%);狭窄形成(3.3%);并在静脉曲张硬化之前再次出血(23%)。
结论:注射硬化疗法未根除大多数儿童的食管静脉曲张。硬化剂引起的注射道栓塞与较少的并发症和降低的再出血率相关。

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