A clinical controlled trial of endoscopic sclerotherapy for repeated esophageal variceal bleeding

1989 ◽  
Vol 24 (1) ◽  
pp. 70-74 ◽  
Author(s):  
Kuo-Liang Wu ◽  
Pai-Dai Chou ◽  
Chao-Ming Huang ◽  
Hung-Shuen Tang ◽  
Chiuan-Fu Chen ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Controlled Trial ◽  
Endoscopic Sclerotherapy ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding

scholarly journals A Randomized Controlled Study of Fuzheng Huayu Capsule for Prevention of Esophageal Variceal Bleeding in Patients with Liver Cirrhosis

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Jie Gu ◽  
Qin Zhang ◽  
Dongying Xue ◽  
Hong Cai ◽  
Lieming Xu
Keyword(s):  
Variceal Bleeding ◽  
Controlled Trial ◽  
Survival Rates ◽  
Controlled Study ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Randomized Controlled ◽  
Cirrhotic Patients ◽  
Upper Gastrointestinal

To elucidate the role of Fuzheng Huayu Capsule, a herbal formula, in the prevention of esophageal variceal bleeding in cirrhotic patients, a multicenter randomized and placebo-controlled trial was carried out. One hundred forty-six cirrhotic patients with esophageal varices were enrolled to compare the probability of upper gastrointestinal bleeding and survival between Fuzheng Huayu Capsule group and controlled group for the duration of 2 years. The results demonstrated that the FZHYC could effectively reduce the risk of variceal bleeding and improve survival rates for cirrhotic patients with varices, especially the combination of the capsule and Propranolol, which presented a better effect; FZHYC could reduce the varices size in patients with small ones. Its effect may be related to the amelioration of hepatic fibrosis.

Sclerotherapy of esophageal varices in hemophilia patients with liver cirrhosis – a prospective, controlled clinical study

2018 ◽  
Vol 90 (1) ◽  
pp. 29-34
Author(s):  
Andrzej B. Szczepanik ◽  
Konrad Pielaciński ◽  
Anna M. Oses-Szczepanik ◽  
Sławomir Huszcza ◽  
Andrzej Misiak ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Esophageal Varices ◽  
Variceal Bleeding ◽  
Hemophilia A ◽  
Secondary Prophylaxis ◽  
Severe Form ◽  
Control Group ◽  
Endoscopic Sclerotherapy ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding

Introduction: Bleeding from esophageal varices is a serious clinical condition in hemophilia patients due to congenital deficiency or lack of clotting factors VIII (in hemophilia A) and IX (in hemophilia B), decreased clotting factor II, VII, IX, X synthesis in the course of chronic liver disease and hipersplenic thrombocytopenia. The aim of this study was to assess the efficacy and safety of endoscopic sclerotherapy in acute esophageal variceal bleeding and in secondary prophylaxis of hemorrhage. The aim was also to investigate the optimal activity of deficiency factors VIII or IX and duration of replacement therapy required to ensure proper hemostasis after sclerotherapy procedures. Material and methods: 22 hemophilia patients (A-19, B-4) with coexistent liver cirrhosis and active esophageal variceal bleeding treated with endoscopic sclerotherapy were subjected to prospective analysis. The patients who survived were qualified to repeated sclerotherapy procedures every 3 weeks within secondary prophylaxis of bleeding (investigated group). A 3-day substitution therapy enhanced the infusion of the deficient or lacking factor in doses allowing to reach 80-100% of normal value activity of factor VIII on the 1st day and 60-80% in the next two days. The desired activity of factor IX was 60- 80% and 40-60% respectively. The control group consisted of 20 non-hemophiliac patients with liver cirrhosis comparable in terms of age, sex, stage of advancement of liver cirrhosis, who underwent the same medical proceedings as the investigated group. Results: Active esophageal bleeding was stopped in 21 of 22 (95%) hemophilia patients. Complications were observed in 3 patients; 2 patients died. The rate of hemostasis, complications and deaths in the control group were comparable and no statistical differences were found. In hemophilia patients subjected to secondary prophylaxis of hemorrhage, in 18 of 20 (80%), complete eradication of esophageal varices was achieved after 4 to 7 sclerotherapy procedures in 1 patient (average 5.4). Recurrent bleeding was observed in 15% of patients, complication in 20%; 1 patient died. Time lapse from bleeding to eradication was 12-21 weeks (average 15.2). In the control group the rate of variceal eradication, complication and deaths was comparable and no statistical differences were found. The usage of factor VIII concentrates was as follows: in hemophilia A, in a severe form - 80.9 U/kg b.w./day, in hemophilia A in a severe form with an inhibitor <5 BU – 95.2 U/kg b.w./day, in mild form – 64.2 U/kg b.w./day and in severe hemophilia B – 91.6 U/kg b.w./day. Conclusions: Sclerotherapy is an effective method in the management of esophageal variceal bleeding in hemophilia patients. It is also effective for total eradication of varices when applied as a secondary prophylaxis of hemorrhage. In our opinion, a 3-day replacement therapy at the applied doses is sufficient to ensure hemostasis and avoid bleeding complications.

A randomized controlled trial comparing octreotide and vasopressin in the control of acute esophageal variceal bleeding

1992 ◽  
Vol 16 (3) ◽  
pp. 320-325 ◽  
Author(s):  
Shinn-Jang Hwang ◽  
Han-Chieh Lin ◽  
Chia-Fu Chang ◽  
Fa-Yauh Lee ◽  
Chi-Wen Lu ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Variceal Bleeding ◽  
Controlled Trial ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Randomized Controlled
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