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【目的】比较应用内镜治疗肝硬化食管静脉曲张出血不同方法的疗效。【方法】对８１例肝硬化食管静脉曲张出血的病人随机采用套扎治疗（ＥＶＬ）或硬化治疗（ＥＶＳ），治疗后每３个月及再出血时接受内镜检查。【结果】ＥＶＳ组平均随访期（４１４±３８）ｄ，ＥＶＬ组（３９８±３５）ｄ。两组静脉曲张消除率相似（ＥＶＳ组９２５％，ＥＶＬ组９２７％，Ｐ＞０．０５）；ＥＶＬ组达到完全消除所需的平均治疗次数较少（２．７±０．３比３．６±０．１，Ｐ＜００５），但所需时间较长（３８±２．５比２２±２．０，Ｐ＜０．０１）；ＥＶＳ组的并发症率明显高于ＥＶＬ组（２０．０％比０％，Ｐ＜００５），但ＥＶＬ组静脉曲张复发率较高（３６６％比１２．５％，Ｐ＜０．０５）；两组的再出血率及死亡率比较差异无显著性（２０．０％比１７１％；２７．５％比２１．９％，均Ｐ＞０．０５）。【结论】两种方法疗效相似，ＥＶＬ在短期随访中优点突出，而随时间延长，静脉曲张复发率较高，所有患者第１年随访期均需接受频繁的内镜检查。
【Objective】 To compare the curative effect of different methods of endoscopic treatment of hepatic cirrhosis esophageal variceal bleeding. 【Methods】 Eighty-one patients with cirrhosis and esophageal variceal bleeding were randomized to receive ligation or EVS. All patients underwent endoscopic examination every 3 months and after re-bleeding. 【Results】 The average follow-up period was 414 ± 38 days in EVS group and 398 ± 35 days in EVL group. The rate of varicocelectomy was similar in both groups (92.5% in EVS group and 92.7% in EVL group, P> 0.05). The mean number of treatments required for complete elimination of EVL group was less (2.7 ± 0.3 Than 3.6 ± 0.1, P <005), but the time required was longer (38 ± 2.5 vs 22 ± 2.0, P <0.01). The complication rate in EVS group was significantly higher (20.0% vs 0%, P <005), but the recurrence rate of varices in EVL group was higher (36.6% vs 12.5%, P <0.05) Bleeding rate and mortality were not significantly different (20.0% vs 17.1%; 27.5% vs. 21.9%, all P> 0.05). 【Conclusion】 The two methods have similar curative effect. The EVL has obvious advantages in short-term follow-up. With the prolongation of time, the recurrence rate of varicose veins is higher. All patients should undergo frequent endoscopy in the first year of follow-up.