肝硬化食管胃底静脉曲张内科治疗进展

Update on medical treatment of variceal hemorrhage in liver cirrhosis

食管胃底静脉曲张破裂出血是肝硬化患者的严重并发症和主要死亡原因。防止原发性首次食管胃底静脉曲张破裂出血(FVB)和预防再出血十分重要。β-肾上腺素受体阻滞剂(β-Ab)列为首选防止FVB的一线药物,对高危性食管静脉曲张者主张行预防性治疗。β-Ab或与EVL合用亦是预防再出血的首选治疗方法。对急性食管胃底静脉曲张破裂出血,药物治疗仍为首选措施,内镜疗法用于药物疗法失败病例。

Esophageal and gastric variceal hemorrhage is a serious complication and a main cause of mortality in liver cirrhosis patients. It is significantly important to prevent the initial variceal bleeding and rebleeding in cirrhosis patients. Betablockers is the first choice of first-line therapy for primary prophylaxis against initial variceal hemorrhage. It is recommended that prophylaxis should be given to cirrhosis patients with high-risk esophageal varices. Beta-blockers or/and EVL also are the best therapies for prevention of rebleeding. For acute esophageal and gastric variceal hemorrhage, pharmacological therapy is still the frist choice. Endoscopic treatment can be used for those patients who are failured to pharmocological treatments.