内镜下治疗食管-胃连通型静脉曲张的研究进展

崔美兰; 闫会敏; 郑欢伟

doi:10.3969/j.issn.1001-5256.2020.01.045

内镜下治疗食管-胃连通型静脉曲张的研究进展

DOI: 10.3969/j.issn.1001-5256.2020.01.045

1. 石家庄市第五医院消化科
2. 石家庄市第五医院临床医学研究中心

基金项目:

河北省卫生厅2016年医学科学研究重点课题计划(20160783)；

详细信息

中图分类号: R575.2
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出版历程
- 收稿日期: 2019-07-29
- 出版日期: 2020-01-20

Research advances in endoscopic treatment of esophageal and gastric varices

Department of digestive,Shijiazhuang Fifth Hospital

Research funding:

摘要

摘要: 食管胃静脉曲张破裂出血是肝硬化常见且危重的并发症之一,再出血率及病死率高,食管-胃连通型静脉曲张属于特殊类型静脉曲张,内镜下治疗方法主要包括内镜下静脉曲张硬化术、内镜下组织胶注射及联合序贯治疗等,但在具体方法的选择上还存在一些争议。现就近年来国内外食管-胃连通型静脉曲张内镜下治疗的进展予以综述。
- 肝硬化 /
- 食管和胃静脉曲张 /
- 内窥镜检查,消化系统
Abstract: Gastroesophageal variceal bleeding is one of the most common and critical complications of liver cirrhosis,with high rebleeding and mortality rates. Esophageal and gastric varices is a special type of varices,and endoscopic treatment methods for this disease include endoscopic variceal sclerotherapy,endoscopic tissue adhesive injection,and combined sequential therapy,but there are still controversies over the selection of specific treatment method. This article reviews the recent research advances in the endoscopic treatment of esophageal and gastric varices in China and foreign countries.
- liver cirrhosis /
- esophageal and gastric varices /
- endoscopy,digestive system

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参考文献(43)

[1] Chinese Society of Hepatology,Chinese Medical Association;Chinese Society of Gastroenterology,Chinese Medical Association; Chinese Society of Endoscopy,Chinese Medical Association. Guidelines for the diagnosis and treatment of esophageal and gastric variceal bleeding in cirrhotic portal hypertension[J]. J Clin Hepatol,2016,32(2):203-219.(in Chinese)中华医学会肝病学分会，中华医学会消化病学分会，中华医学会内镜学分会．肝硬化门静脉高压食管胃静脉曲张出血的防治指南[J]．临床肝胆病杂志，2016,32(2):203-219.

[2] DAI YP,GAO Q. A prognostic analysis of cirrhotic esophageal variceal bleeding treated with standardized endoscopic therapy[J]. Chin J Hepatol,2017,25(3):195-199.(in Chinese)戴晏平，高青．规范化内镜治疗肝硬化食管静脉曲张出血的预后分析[J]．中华肝脏病杂志，2017,25(3):195-199.

[3] TOSHIKUNI N,TAKUMA Y,TSUTSUMI M. Management of gastroesophageal varices in cirrhotic patients:Current status and future directions[J]. Ann Hepatol,2016,15(3):314-325.

[4] CABRERA L,TANDON P,ABRALDES JG. An update on the management of acute esophageal variceal bleeding[J]. Gastroenterol Hepatol,2016,40(1):34-40.

[5] de FRANCHIS R,Baveno VI Faculty. Expanding consensus in portal hypertension:Report of the Baveno VI Consensus Workshop:Stratifying risk and individualizing care for portal hypertension[J]. J Hepatol,2015,63(3):743-752.

[6] WU YL,WU W,SHI W,et al. Endoscopic features and classification of gastric varices in patients with portal hypertension[J]. Chin J Gastroenterol,2007,12(6):335-338.(in Chinese)吴云林，吴巍，史玮，等．门静脉高压患者胃静脉曲张的内镜识别和分类[J]．胃肠病学，2007,12(6):335-338.

[7] LI L,ZHANG WH,HAN J,et al. The endoscopic feature of varices in 1078 liver cirrhosis[J]. Chin J Endosc,2014,20(2):157-160.(in Chinese)李莉，张文辉，韩军，等．1078例食管胃静脉曲张内镜下表现特点[J]．中国内镜杂志，2014,20(2):157-160.

[8] ZHU CY,SHI W,WU YL,et al. Endoscopic classification of gastric varices with portal hypertension[J]. Chin J Clin Gastroenterol,2008,20(5):273-276.(in Chinese)朱春燕，史玮，吴云林，等．门脉高压胃静脉曲张的内镜分类[J]．临床消化病杂志，2008,20(5):273-276.

[9] TRIPATHI D,STANLEY AJ,HAYES PC,et al. U. K. guidelines on the management of variceal haemorrhage in cirrhotic patients[J]. Gut,2015,64(11):1680-1704.

[10] LIN YQ,JIANG B,LI HQ,et al. Application of hepatic transit time in portal vein pressure assessment in patients with portal hypertension and esophago gastric varices[J]. J Jilin Univ(Med Edit),2019,45(1):170-174,220.(in Chinese)林元强，姜博，李鹤群，等．肝脏渡越时间在门静脉高压-食管胃底静脉曲张患者门静脉压力评估中的应用[J]．吉林大学学报(医学版)，2019,45(1):170-174,220.

[11] GUO QT,MA C,LI MM,et al. Efficacy and safety of modified sclerotherapy for Le,g type esophageal and gastric variceal bleeding[J]. Chin J Dig,2019,39(6):409-411.(in Chinese)郭庆涛，马超，李明明，等．改良硬化治疗对Le,g型食管胃静脉曲张破裂出血的疗效和安全性[J]．中华消化杂志，2019,39(6):409-411.

[12] YU ZG,LIN YH,HUANG WF,et al. Clinical efficacy and safety of different endoscopy methods in patients with liver cirrhosis complicated with esophagogastric varicosity bleeding[J].J Clin Exp Med,2018,17(8):813-816.(in Chinese)余中贵，林燕华，黄文峰，等．不同内镜方案对肝硬化合并食管胃底静脉曲张破裂出血患者临床疗效及安全性分析[J]．临床和实验医学杂志，2018,17(8):813-816.

[13] CHEN LQ,CAO JB,XIONG JH,et al. Analysis of 356 cases of esophageal variceal bleeding due to cirrhosis treated with sclerosing agent under gastroscope[J/CD]. Chin J Clinicians(Electronic Edition),2011,5(20):6144-6146.(in Chinese)陈力强，曹建彪，熊锦华，等．胃镜下硬化剂治疗肝硬化食管静脉曲张破裂出血356例分析[J/CD]．中华临床医师杂志(电子版)，2011,5(20):6144-6146.

[14] LI C,LI J,HAN T. Effect of endoscopic-guided ligation combined with somatostatin on portal hemodynamics in patients with esophageal variceal bleeding[J]. Clin J Med Offic,2018,46(11):1352-1353,1355.(in Chinese)李超，李京，韩涛．内镜引导下套扎术联合生长抑素对食管静脉曲张破裂出血患者门脉系血流动力学影响[J]．临床军医杂志，2018,46(11):1352-1353,1355.

[15] CHEN QL,HAN YM,ZHU YQ,et al. Ethyl alcohol lauromacrogol hardening treatment of esophageal variceal bleeding compared the efficacy and complications[J]. Shaanxi Med J,2014,43(3):349-350.(in Chinese)陈巧玲，韩一梅，朱云清，等．乙氧硬化醇和聚桂醇治疗食管静脉曲张破裂出血疗效及并发症比较[J]．陕西医学杂志，2014,43(3):349-350.

[16] WANG TW,LI XM,DONG L,et al. Curative effect of sclerosing agent and tissue glue in the treatment of esophageal and gastric varices[J]. Ningxia Med J,2011,33(1):34-35.(in Chinese)王铁武，李西梅，董琳，等．硬化剂和组织胶在治疗食管胃底静脉曲张中的疗效观察[J]．宁夏医学杂志，2011,33(1):34-35.

[17] LIU BY,LEI YF,YANG CE. The significance of LDRf classification in diagnosis and treatment of endoscope for gastroesophageal varices[J/CD]. Chin J Laparoscopic Surgery(Electronic Edition),2012,5(5):27-29.(in Chinese)刘变英，雷宇峰，杨嫦娥．LDRf分型方法在内镜诊治食管胃静脉曲张中的意义[J/CD]．中华腔镜外科杂志(电子版)，2012,5(5):27-29.

[18] YAN WJ,CHAI GJ,YANG YS,et al. Related factor analysis of esophageal stricture following esophageal variceal sclerotherapy[J]. Med J Chin PAP,2012,23(5):386-388,391.(in Chinese)闫文姬，柴国君，杨云生，等．食管静脉曲张硬化治疗后食管发生狭窄的相关因素[J]．武警医学，2012,23(5):386-388,391.

[19] DENG J,ZHAO QC. Risk factors for treatment failure of cirrhosis with acute esophagogastric variceal bleeding[J]. Clin J Med Offic,2019,47(9):954-956.(in Chinese)邓娇，赵庆春．肝硬化伴急性食管胃底静脉曲张破裂出血治疗失败危险因素分析[J]．临床军医杂志，2019,47(9):954-956.

[20] BIAN F,ZHANG GL,WANG FM,et al. Clinical effect of endoscopic tissue adhesive injection versus its combination with modified lauromacrogol sandwich injection in treatment of gastric varices[J]. Chin J Hepatol,2016,24(10):786-789.(in Chinese)边芬，张国梁，王凤梅，等．内镜下组织胶传统注射与联合聚桂醇改良三明治夹心法注射治疗胃静脉曲张的疗效比较[J]．中华肝脏病杂志，2016,24(10):786-789.

[21] LIN H,TIAN F,XU J,et al. Curative effect of simultaneous injection of tissue adhesive and cinnamyl alcohol under gastroscope on varicose veins of stomach fundus[J/CD]. Chin J Clinicians(Electronic Edition),2016,10(18):2803-2805.(in Chinese)林海，田峰，徐建，等．胃镜下同时注射组织粘合剂与聚桂醇治疗胃底曲张静脉的疗效[J/CD]．中华临床医师杂志(电子版)，2016,10(18):2803-2805.

[22] LIU ZZ,ZHAO YY,SUN YJ,et al. Curative effect of single injection of sclerosing agent and tissue adhesive on variceal hemorrhage of gastric fundus[J]. Chin J Dig,2014,34(3):183-184.(in Chinese)刘志忠，赵燕颖，孙远杰，等．一次性注射硬化剂加组织黏合剂治疗胃底曲张静脉出血的疗效观察[J]．中华消化杂志，2014,34(3):183-184.

[23] HE ZD,SUN G,JIANG H,et al. Treatment of gastroesophageal varices of Le,g type with endoscopic tissue adhesive injection combined with sequential endoscopic variceal ligation[J]. Chin J Dig Endosc,2015,32(12):800-803.(in Chinese)何占娣，孙刚，江华，等．内镜组织胶注射序贯套扎治疗Le,g型食管胃静脉曲张[J]．中华消化内镜杂志，2015,32(12):800-803.

[24] LIU SL,WANG DX,ZHENG JM,et al. Curative effect after endoscopic sequential therapy for esophageal gastric varices of cirrhosis[J]. Chin J Endosc,2018,24(12):99-103.(in Chinese)刘素丽，王鼎鑫，郑吉敏，等．内镜序贯治疗肝硬化食管胃底静脉曲张的疗效分析[J]．中国内镜杂志，2018,24(12):99-103.

[25] LIN H,XU XG,XUE FX,et al. Comparison of injecting tissue glue and lauromacrogol in modified sandwich method with synchronization or sequential ligation for esophageal and gastric variceal[J]. Chin J Endosc,2017,23(2):6-9.(in Chinese)林海，徐晓光，薛方喜，等．改良三明治法同步与序贯联合套扎治疗食管胃底静脉曲张的疗效比较[J]．中国内镜杂志，2017,23(2):6-9.

[26] ZENG QX,WU ZH,DONG Y,et al. Observation of short and long term effects of injecting in modified sandwich method with variceal ligation on esophageal gastric varices bleeding[J].Shanxi Med J,2018,47(5):491-494.(in Chinese)曾权祥，吴振华，董颖，等．内镜套扎术联合改良三明治法注射治疗食管胃底静脉曲张出血的近远期疗效观察[J]．山西医药杂志，2018,47(5):491-494.

[27] ZHONG LY. Follow-up study of tissue glue combined with ligation in the treatment of esophageal and gastric varices bleeding[J]. Mod Digest Interv,2019,24(1):46-49.(in Chinese)钟丽艳．组织胶联合套扎术治疗食管胃底静脉曲张破裂出血的随访研究[J]．现代消化及介入诊疗，2019,24(1):46-49.

[28] DIAO YH,HE DL,DAI B,et al. Analysis of prognostic factors in patients with esophageal and gastric varices bleeding after endoscopic injection of tissue adhesive combined with polidocanol[J]. Chin J Modern Med,2017,27(11):117-121.(in Chinese)刁云辉，贺东黎，戴兵，等．组织胶联合聚桂醇急诊内镜下注射治疗食管胃底静脉曲张破裂后出血预后因素分析[J]．中国现代医学杂志，2017,27(11):117-121.

[29] YANG YF,WANG JP,HAN Y,et al. Clinical observation on the treatment of esophageal-gastric variceal hemorrhage by modified injection of tissue glue and sclerotherapy[J]. Chin Remed Clin,2018,18(10):1727-1729.(in Chinese)杨云锋，王俊平，韩轶，等．组织胶改良注射方法联合硬化治疗食管-胃底静脉曲张出血的临床疗效观察[J]．中国药物与临床，2018,18(10):1727-1729.

[30] LI P,WEI HS,JIANG Y,et al. Endoscopic selective varices devascularization:Effects of once endotherapy for esophageal and gastric varices[J]. J Internal Intensive Med,2017,23(4):284-288,329.(in Chinese)李坪，魏红山，蒋煜，等．精准贲门胃静脉曲张断流术:一次性治疗食管胃连通型静脉曲张的近期疗效[J]．内科危急重症杂志，2017,23(4):284-288,329.

[31] CAO CK,KONG DR,XIAO T. Prospective study on 180 cases of endoscopic selective varies devascularization[J]. Chin J Endosc,2018,24(25):103-108.(in Chinese)曹传坤，孔德润，肖婷．内镜下精准食管胃静脉曲张断流术的前瞻性研究(附180例报告)[J]．中国内镜杂志，2018,24(25):103-108.

[32] KONG DR,XU JM. Selection and application of endoscopic treatments for gastroesophageal varices[J/CD]. Chin J Gastrointestinal Endoscopy(Electronic Edition),2016,3(4):171-176.(in Chinese)孔德润，许建明．食管胃静脉曲张内镜下治疗方法的选择与应用[J/CD]．中华胃肠内镜电子杂志，2016,3(4):171-176.

[33] HERRERA JL. Management of acute variceal bleeding[J].Clin Liver Dis,2014,18(2):347-357.

[34] HWANG JH,SHERGILL AK,ACOSTA RD,et al. The role of endoscopy in the management of variceal hemorrhage[J].Gastrointest Endosc,2014,80(2):221-227.

[35] GARCIA-PAGDN JC,BARRUFET M,CARDENAS A,et al.Management of gastric varices[J]. Clin Gastroenterol Hepatol,2014,12(6):919-928.

[36] GE SQ,DONG L,WAN XL,et al. Endoscopic variceal ligation and endoscopic variceal obturation for the management of gastric varices:A prospective com parative study[J/CD].Chin J Gastrointestinal Endoscopy(Electronic Edition),2015,2(1):6-13.(in Chinese)葛淑琼，董蕾，万晓龙，等．胃静脉曲张内镜下套扎治疗与组织黏合剂注射治疗前瞻性研究[J/CD]．中华胃肠内镜电子杂志，2015,2(1):6-13.

[37] XU H,CHEN G,SUN Y,et al. U type retroflexion ligation therapy in esophageal and gastricvarices[J]. Chin J Dig Endosc,2010,27(4):182-185.(in Chinese)徐红，陈更，孙岩，等．“U型”反转套扎技术在食管胃静脉曲张治疗中的应用[J]．中华消化内镜杂志，2010,27(4):182-185.

[38] ZHENG FP,GUO YW,LIN XY,et al. A randomized controlled trial of endoscopic treatment of acute gastric variceal hemorrhage:N-butyl-2-cyanoacrylate injection versus band ligation[J/CD]. Chin J Hepat Surg(Electronic Edition),2012,1(2):118-122.(in Chinese)郑丰平，郭云蔚，林显艺，等．内镜下胃静脉套扎术治疗肝硬化门静脉高压急性胃底静脉曲张出血的随机对照研究[J/CD]．中华肝脏外科手术学电子杂志，2012,1(2):118-122.

[39] LI HX,MA C,ZHANG LY,et al. Muiticenter clinical study of endoscopic variceal ligation in the treatment of 61 cases of type 1 gastroesophageal varices bleeding[J]. Chin J Dig,2018,38(10):669-672.(in Chinese)李会贤，马超，张丽瑶，等．皮圈套扎治疗1型胃食管静脉曲张出血61例的多中心临床研究[J]．中华消化杂志，2018,38(10):669-672.

[40] ZHANG H,WEN JJ,ZUO F,et al. Endoscopic ligation of esophageal varices in the treatment of cirrhotic esophageal varices:A clinical observation of 56 cases[J]. Shandong Med J,2015,55(2):63-65.(in Chinese)张晖，文进军，左凡，等．内镜下食管静脉曲张套扎术治疗肝硬化食管静脉曲张56例疗效观察[J]．山东医药，2015,55(2):63-65.

[41] ZHANG XL,GAO ZX,JIAO JX. Analyzing the clinical curative effect of 56 patients with esophageal variceal bleeding who received esophageal variceal ligation[J]. Acta Acad Med Weifang,2014,36(4):276-278.(in Chinese)张晓亮，高志星，焦建新．食管静脉曲张套扎56例临床疗效分析[J]．潍坊医学院学报，2014,36(4):276-278.

[42] MASALAITE L,VALANTINAS J,STANAITIS J. The role of collateral veins detected by endosonography in predicting the recurrence of esophageal varices after endoscopic treatment:A systematic review[J]. Hepatol Int,2014,8(3):339-351.

[43] ZHOU JW,LIN YS,LIN XZ,et al. Endoscopic variceal ligation versus endoscopic variceal sclerotherapy in treatment of esophageal variceal bleeding:A meta-analysis[J]. Chin J Endosc,2017,23(1):39-46.(in Chinese)周江伟，林叶素，林细州，等．内镜下套扎与硬化剂治疗食管静脉曲张破裂出血疗效的Meta分析[J]．中国内镜杂志，2017,23(1):39-46.

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