Johnson W C, Nabseth D C, Widrich W C, Bush H L, O'Hara E T, Robbins A H
Ann Surg. 1982 Apr;195(4):393-400. doi: 10.1097/00000658-198204000-00003.
The fate of 359 consecutive alcoholic cirrhotic male patients with bleeding esophageal varices was determined through chart review and personal interview. Three historical periods (1966-70; 1971-75; 1976-80) were defined based on availability of different therapeutic modalities. Management of acutely bleeding varices by conservative, nonsurgical means, including embolization, was preferable to emergency surgery when considering 30-day mortality rates. Percutaneous transhepatic embolization of esophagogastric varices significantly improved the rate of control of hemorrhage and 30-day survival over previously employed nonsurgical methods. The combination of nonsurgical management of acute variceal hemorrhage followed by selective distal splenorenal shunting resulted in maximum salvage of the alcoholic cirrhotic patient.
通过病历审查和个人访谈，确定了359例连续性酒精性肝硬化伴食管静脉曲张出血男性患者的预后。根据不同治疗方式的可获得性，定义了三个历史时期（1966 - 1970年；1971 - 1975年；1976 - 1980年）。在考虑30天死亡率时，采用包括栓塞术在内的保守非手术方法处理急性出血性静脉曲张优于急诊手术。与之前采用的非手术方法相比，经皮经肝食管胃静脉曲张栓塞术显著提高了出血控制率和30天生存率。急性静脉曲张出血的非手术治疗联合选择性远端脾肾分流术，可最大程度挽救酒精性肝硬化患者。
