日本的食管胃静脉曲张内镜治疗。
Endoscopic management of esophagogastric varices in Japan.
机构信息
Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
出版信息
Ann Transl Med. 2014 May;2(5):42. doi: 10.3978/j.issn.2305-5839.2014.05.02.
Abstract
Esophagogastric varices are the most common complication in patients with portal hypertension, and endoscopy plays an important role in their diagnosis and in the prevention of acute bleeding from these structures. Recently, new modalities such as endoscopic ultrasonography (EUS) and narrow-band imaging have been introduced for the diagnosis of esophagogastric varices. In Japan, endoscopic therapy has become the first choice for the treatment of acutely bleeding esophageal or gastric varices. The two principal methods used to treat esophageal varices are endoscopic injection sclerotherapy (EIS) and endoscopic variceal ligation (EVL). Recently, combinations of EIS plus EVL and EVL plus argon plasma coagulation were reported to be more effective than EVL or EIS alone. Additionally, endoscopic cyanoacrylate injection is superior to EIS and EVL for the treatment of acutely bleeding gastric varices.
摘要
食管胃静脉曲张是门静脉高压症患者最常见的并发症，内镜检查在其诊断和预防这些结构的急性出血方面发挥着重要作用。最近，一些新的方法，如内镜超声检查（EUS）和窄带成像技术，已被引入用于食管胃静脉曲张的诊断。在日本，内镜治疗已成为治疗急性出血性食管或胃静脉曲张的首选方法。治疗食管静脉曲张的两种主要方法是内镜下注射硬化疗法（EIS）和内镜下静脉曲张结扎术（EVL）。最近，有报道称 EIS 加 EVL 以及 EVL 加氩等离子凝固术的联合治疗比单独使用 EVL 或 EIS 更有效。此外，对于治疗急性出血性胃静脉曲张，内镜氰基丙烯酸酯注射优于 EIS 和 EVL。
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