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在上消化道出血中,食管静脉曲张(esophagealvarice,EV)破裂出血占2.6％～24.8％,而肝硬化患者至少有1/3要并发EV破裂出血,首次出血病死率可达50％。内科疗法的近期或远期疗效均不令人满意,外科分流术虽能防止出血,却使肝脏功能更加恶化,再出血屡见不鲜,远期生存率并不乐观。近年来,由于纤维内窥镜的问世和不断完善,内窥镜硬化剂注射法(endoscopic sclerosis,ES)又称硬化疗法(sclerotherapy)在英国、德国和南非等作为暂时止血的手段,获得较好的疗效,特别对严重肝损害的病人值得试用。 EV多位于食管下段粘膜下。日本的向坂健男将EV依其形态分三型:即形态上轻度曲张者(F_1)是
In upper gastrointestinal bleeding, esophageal varice (EV) rupture and hemorrhage accounts for 2.6% ~ 24.8%, while at least 1/3 of patients with cirrhosis have EV rupture and the first case fatality rate can reach 50%. The medical treatment of the short-term or long-term efficacy are not satisfactory, although surgical shunt to prevent bleeding, but to make the liver function worsened, recurrence of bleeding is uncommon, long-term survival is not optimistic. In recent years, due to the advent and continuous improvement of fiber endoscopy, endoscopic sclerosis (ES), also known as sclerotherapy, has been used as a temporary hemostasis measure in the United Kingdom, Germany and South Africa to obtain better The efficacy, especially for patients with severe liver damage worth trying. EV more in the lower esophageal mucosa. Japan Sakamoto male EV will be divided into three types according to their form: that is morphologically mild varicose (F_1) is