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食道静脉曲张出血的治疗是临床上的一大难题,其治疗方法的选择尚存在争论。由于手术疗法伴有较高的死亡率,因而近年来人们对非手术疗法给予了较多的关注。古老的疗法如内窥镜硬化剂疗法得到复活,新的疗法如血管造影栓塞术等不断涌现,这一切为食道静脉曲张出血的治疗开辟了新的前景。现将近几年来国内外在非手术疗法方面的进展综述如下。一、药物治疗 1.垂体加压素(vasopressin or pitressin) 垂体加压素因可降低门脉压力和收缩食道肌肉而产生止血效果。Kehne氏于1956年首先使用加压素治疗食道静脉曲张出血,目前已成为第一线使用药物。给药方法有静脉一次注入、静脉连续滴注和肠系膜上动脉滴注3种。
The treatment of esophageal variceal bleeding is a major clinical problem, the choice of treatment is still controversial. In recent years, people have given more attention to non-surgical treatment due to the higher death rate associated with surgical treatment. Ancient therapies such as endoscopic sclerosant therapy are resuscitated and new therapies such as angiography and embolization continue to emerge, opening up new prospects for the treatment of esophageal variceal bleeding. Now in recent years at home and abroad in the progress of non-surgical treatment are summarized below. First, the drug treatment 1. Pituitary vasopressin (vasopressin or pitressin) Pituitary vasopressin can reduce the portal pressure and contraction of the esophagus muscles to produce hemostatic effect. Kehne’s first use of vasopressin in the treatment of esophageal variceal bleeding in 1956, has now become the first line of use of drugs. There are intravenous infusion method, continuous intravenous infusion and superior mesenteric artery infusion of three kinds.