Jutabha R, Jensen D M
Department of Medicine, University of California, Los Angeles School of Medicine 90095-1684, USA.
Med Clin North Am. 1996 Sep;80(5):1035-68. doi: 10.1016/s0025-7125(05)70479-x.
This article reviews the management of severe upper gastrointestinal bleeding in the patient with chronic liver diseases. The initial assessment, diagnostic work-up, and treatment options for variceal and nonvariceal bleeding are discussed. The role of diagnostic and therapeutic endoscopy for esophagogastric varices is reviewed with special emphasis on new endoscopic techniques including variceal band ligation and cyanoacrylate injection. Various pharmacologic, surgical, and radiologic treatment options for variceal bleeding also are discussed. In addition, nonvariceal causes of severe upper gastrointestinal bleeding are reviewed including peptic ulcer diseases, Mallory-Weiss tear, portal hypertensive gastropathy, and gastric antral vascular ectasia.
本文综述了慢性肝病患者严重上消化道出血的管理。讨论了静脉曲张性和非静脉曲张性出血的初始评估、诊断检查及治疗选择。回顾了诊断性和治疗性内镜检查在食管胃静脉曲张中的作用，特别强调了包括静脉曲张套扎术和氰基丙烯酸酯注射在内的新内镜技术。还讨论了静脉曲张出血的各种药物、手术和放射治疗选择。此外，还综述了严重上消化道出血的非静脉曲张病因，包括消化性溃疡病、马洛里-魏斯撕裂、门静脉高压性胃病和胃窦血管扩张症。
