论文部分内容阅读
近40多年来食管静脉曲张破裂出血的死亡率和发病率几乎无甚改观。最近几年报告的资料均表明尽管治疗静脉曲张破裂出血手段众多,包括外科手术、填塞出血曲张静脉及热凝等,但无一种卓有成效的方法。有鉴于此,利用药物治疗之途径异军崛起。许多药物如心得安、生长激素释放抑制激素(somatostatin)加压素、甲腈咪胍以及呋喃硝胺等均被试用。其中最值得注意的是使用心得安长期治疗那些新近出血但无活动性出血的静脉曲张。心得安治疗静脉曲张/门脉高压的主要作用是减少心脏指数,从而减低门脉压力。但是,也可能有一个直接降低门脉压力的作用。 1980年,Lebrec等在法国首次报道肝硬化和门
Nearly 40 years of esophageal variceal bleeding mortality and morbidity almost no change. The data reported in recent years indicate that although there are many means of treating variceal bleeding, including surgery, filling of bleeding varicose veins and thermal coagulation, there is no effective method. In view of this, the use of medical treatment of the sudden emergence of the route. Many drugs such as propranolol, somatostatin (somatostatin) vasopressin, cimetidine, and ranitidine were tested. One of the most noteworthy is the use of long-term treatment of those with recent bleeding but no active bleeding varicose veins. Treatment of varicose veins / portal hypertension The main role is to reduce the cardiac index, thereby reducing portal pressure. However, there may also be a direct reduction in portal pressure. In 1980, Lebrec et al. First reported cirrhosis and portal in France