高位食管静脉曲张破裂出血的急诊内镜诊治现状

The status of emergency endoscopic diagnosis and treatment of superior esophageal variceal bleeding

食管静脉曲张破裂出血是消化系统常见的致命性疾病之一。随着我国肝硬化患病率的增加,食管静脉曲张破裂出血作为其严重并发症之一的发生率也逐年递增。高位食管位于食管入口至气管分叉之间,即距门齿25 cm以内,此处静脉曲张发生破裂出血者罕见。有少量病例报道称此类患者行内镜下食管静脉曲张套扎术后,即时止血效果良好,但尚无相关的针对性治疗方案及预后研究。急诊内镜广泛应用于临床,是诊治上消化道不明原因出血的首选方案。现就高位食管静脉曲张破裂出血的急诊内镜诊治现状作一概述。

Esophageal variceal bleeding is one of the common fatal diseases of the digestive system.With the increase of the prevalence of cirrhosis in China,esophageal variceal bleeding as one of the serious complications of cirrhosis also has an increasing incidence year by year.The superior esophagus located between the entrance of esophagus and the trachea bifurcation,that is,within 25 cm from the incisors,where bleeding from varicose veins is rare.A few cases reported that the endoscopic variceal ligation has a good immediate hemostasis effect on this kind of patients,but there was no relevant targeted treatment and prognosis study.Emergency endoscopy is widely used in clinic and is the first choice for the diagnosis and treatment of unidentified bleeding of upper gastrointestinal tract.This article reviewed the status of emergency endoscopic diagnosis and treatment of superior esophageal variceal bleeding.