Randomized trial of endoscopic injection sclerosis with ethanolamine oleate and ethanol for bleeding peptic ulcer.
| Autor: | Mäkelä JT; Dept. of Surgery, Oulu University Hospital, Finland., Kiviniemi H, Laitinen ST |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Scandinavian journal of gastroenterology [Scand J Gastroenterol] 1996 Nov; Vol. 31 (11), pp. 1059-62. |
| DOI: | 10.3109/00365529609036887 |
| Abstrakt: | Background: Few studies have been done comparing ethanolamine oleate injection therapy with other sclerosing agents. Between September 1992 and August 1995, 78 consecutive patients presenting with a high-risk bleeding ulcer were randomized in a trial comparing endoscopic injection sclerotherapies with ethanolamine oleate and absolute ethanol. Methods: The groups were well matched in terms of sex, age, clinical features, endoscopic findings, and non-steroidal anti-inflammatory drug usage. We recorded in a prospective randomized trial the initial success of endoscopy, the rebleeding rate, permanent hemostasis, treatment failures, the need for surgery, mortality, and factors related to mortality. Results: Initial hemostasis was achieved in 90% (38 of 42) of the ethanolamine oleate group and in 97% (35 of 36) of the ethanol group, and permanent hemostasis in 88% (37 of 42) and 92% (33 of 36), respectively. The rebleeding rate, 7% and 8%; the emergency surgery rate, 10% and 6%; the transfusion requirement, 4.8 +/- 3.3 units and 4.0 +/- 3.0 units; and the 30-day mortality, 12% and 3%, did not differ significantly between the ethanolamine oleate and ethanol groups. Mortality was significantly related to shock at admission, duodenal site of the ulcer, ulcer size greater than 2 cm, and blood transfusion of over 5 units. Conclusion: Endoscopic injection sclerotherapies using ethanolamine oleate or absolute ethanol are safe and equally effective for bleeding peptic ulcers. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|