Woods K L, Qureshi W A
Department of Medicine, Gastroenterology Section, Baylor College of Medicine, The Methodist Hospital, Houston, Texas, USA.
Gastrointest Endosc Clin N Am. 1999 Apr;9(2):253-70.
Recurrent hemorrhage from esophageal varices is a major source of morbidity and mortality in patients with portal hypertension. Esophageal sclerotherapy (EST) and more recently esophageal band ligation (EVL) can obliterate varices in 3-6 treatment sessions. Multiple band ligators make the use of overtubes unnecessary and make the procedure faster and more tolerable for the patient. EVL has several advantages, including fewer complications, fewer treatment sessions to obliteration, lower rebleeding rates, and lower mortality as compared to EST; the other advantages of EVL make it the treatment of choice for bleeding varices and long term management. The recommendations and rational for long term EST and EVL are presented and combination therapy and EUS guided EVL are discussed.
食管静脉曲张反复出血是门静脉高压患者发病和死亡的主要原因。食管硬化疗法（EST）以及最近出现的食管套扎术（EVL）可在3至6次治疗疗程中消除静脉曲张。多个套扎器使外套管的使用不再必要，且该操作对患者而言更快且更易耐受。与EST相比，EVL有几个优点，包括并发症更少、消除静脉曲张所需的治疗疗程更少、再出血率更低以及死亡率更低；EVL的其他优点使其成为出血性静脉曲张治疗和长期管理的首选。本文介绍了长期EST和EVL的建议及理论依据，并讨论了联合治疗和超声内镜引导下的EVL。
