硬化剂在肝硬化食管静脉曲张破裂出血防治中的优化应用  

Role of endoscopic injection sclerotherapy on prevention and therapy of esophageal varices bleeding

作　　者：谭玉勇[1] 乐梅先[1] 刘德良[1] Tan Yuyong;Le Meixian;Liu Deliang(Department of Gastroenterology,the Second Xiangya Hospital,Research Center of Digestive Disease,Central South University.Changsha 410008,China)

机构地区：[1]中南大学湘雅二医院消化内科,中南大学消化病研究中心,长沙410008

出　　处：《中华胃肠内镜电子杂志》2020年第1期39-42,共4页Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition)

基　　金：湖南省重点研发计划(2018SK21311)。

摘　　要：约50%的肝硬化患者初诊时即存在食管胃静脉曲张,尤以食管静脉曲张(EV)常见,且EV的发生率随肝脏疾病严重程度增加而增高(Child-Pugh A 43%、Child-Pugh B 71%、Child-Pugh C 76%)[1]。<5 mm的EV以每年10%的速度进展为大的EV,小EV的年出血率为5%,而大EV可达15%,EV出血后6周内死亡率高达20%[2-4]。急性EV破裂出血停止后再次出血率和死亡率较高,未进行二级预防的EV患者1~2年内再次出血率高达60%,死亡率高达33%[5]。因此EV破裂出血的防治非常重要,内镜干预在EV破裂出血的防治中起重要作用,包括内镜下静脉曲张套扎术(EVL)、内镜下硬化剂注射治疗(EIS)、自膨式金属支架等[5-6]。本文就EIS在EV破裂出血的防治作用做一述评。Esophageal varices bleeding is a serious complication for cirrhotic patients,and endoscopic therapy plays important role in its prevention and treatment.Endoscopic injection sclerotherapy is an effective method for treating esophageal varices bleeding,however its proper indication and standard operation are still in controversy,thus we provide a review on its role on prevention and treatment of esophageal varices bleeding.

关 键 词：管静脉曲张破裂出血 内镜下硬化疗法 肝硬化门静脉高压 

分 类 号：R575.2[医药卫生—消化系统]