Kronberger O, Schnack H, Vyslonzil E
Leber Magen Darm. 1976;6(1):38-42.
Acute hemorrhage from esophageal varices is becoming more and more frequent, implying a poor prognosis for the patient and necessitating dramatic therapeutic procedures by the physician or the surgeon. Regular endoscopic controls of patients with liver cirrhosis and portal hypertension are necessary before the first bleeding occurs in spite of negative X-ray findings of the esophagus, since long-term therapeutic results may be inproved by such controls. Sclerosing the esophageal wall does not occlude the esophageal veins, which do remain open consequently; they are just "displaced" deeper into the mucosa. There are no risks or complications of this procedure especially when esophageal varices are just beginning to form and when the esophageal mucosa is still being intact. Therapeutic results are encouraging, and they are better as compared to the results of emergency shunt or elective shunt surgery. Until short time ago sclerosing the esophageal wall was sort of a preliminary preoperative therapeutic procedure. Today it is a well established therapy in its own right, although it is, as is shunt surgery, symptomatic therapy. It does seem to be superior however to all other forms of therapy aimed at preventing or treating esophageal bleeding, since primary mortality seems to be lower and longterm results seem to be better.
食管静脉曲张急性出血越来越频繁，这意味着患者预后不良，需要医生或外科医生采取激进的治疗措施。尽管食管X线检查结果为阴性，但对于肝硬化和门静脉高压患者，在首次出血发生前进行定期内镜检查是必要的，因为这种检查可能会改善长期治疗效果。硬化食管壁并不能闭塞食管静脉，食管静脉因此仍保持开放；它们只是被“推移”到黏膜更深层。该手术没有风险或并发症，尤其是在食管静脉曲张刚开始形成且食管黏膜仍完整时。治疗效果令人鼓舞，与急诊分流或择期分流手术的效果相比更好。直到不久前，硬化食管壁还算是一种术前初步治疗手段。如今，它本身已是一种成熟的治疗方法，尽管它与分流手术一样，都是对症治疗。然而，它似乎优于所有其他旨在预防或治疗食管出血的治疗方法，因为原发性死亡率似乎更低，长期效果似乎更好。
