肝硬化急性食管胃静脉曲张出血的内镜治疗时机： 争议与挑战

李鑫会; 祁兴顺; 刘晓峰; 樊代明; 王静

doi:10.12449/JCH260526

肝硬化急性食管胃静脉曲张出血的内镜治疗时机：争议与挑战

DOI: 10.12449/JCH260526

李鑫会^{1, 2},
祁兴顺³,
刘晓峰²,
樊代明⁴,
王静^2, , ,

1.
山东第一医科大学（山东省医学科学院）研究生部，济南 250117
2.
中国人民解放军联勤保障部队第九六〇医院消化内科，济南 250031
3.
中国人民解放军北部战区总医院消化内科，沈阳 110840
4.
中国人民解放军空军军医大学西京医院消化内科，西安 710032

基金项目:

国家自然科学基金 (81900467);

山东省医药卫生科技项目 (202303031627)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：李鑫会和王静负责查阅文献及撰写论文；王静和祁兴顺负责提供文章思路；樊代明和刘晓峰负责指导论文撰写并定稿。

详细信息

通信作者:
王静， dolphinj228@hotmail.com （ORCID： 0000-0002-4233-4370）

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出版历程
- 收稿日期: 2025-08-11
- 录用日期: 2025-10-11
- 出版日期: 2026-05-20

Timing of endoscopic treatment for acute esophagogastric variceal bleeding in liver cirrhosis： Controversies and challenges

Xinhui LI^{1, 2},
Xingshun QI³,
Xiaofeng LIU²,
Daiming FAN⁴,
Jing WANG^{2
, ,
,}

1.
Graduate School，Shandong First Medical University & Shandong Academy of Medical Sciences，Jinan 250117，China
2.
Department of Gastroenterology，The 960th Hospital of Joint Logistics Support Force of PLA，Jinan 250031，China
3.
Department of Gastroenterology，General Hospital of Northern Theater Command of PLA，Shenyang 110840，China
4.
Department of Gastroenterology，Xijing Hospital，Air Force Medical University of PLA，Xi’an 710032，China

Research funding:

National Natural Science Foundation of China (81900467);

Shandong Medical and Health Science and Technology Project (202303031627)

More Information

Corresponding author: WANG Jing， dolphinj228@hotmail.com （ORCID： 0000-0002-4233-4370）

摘要

摘要: 急性食管胃静脉曲张出血（AEGVB）是失代偿期肝硬化危及患者生命的并发症之一。内镜是诊断和治疗AEGVB的主要手段，内镜下治疗可控制急性出血并使静脉曲张减轻或消失。然而，目前国内外指南对于AEGVB内镜检查与治疗时机的建议尚不统一。国内外现有研究的证据质量较低，且各研究对“早期内镜”的定义差异较大，结论也不统一。本文围绕国内外肝硬化AEGVB内镜治疗时机的研究进展、最佳治疗时机存在的争议进行综述，并对该领域未来的研究方向作出展望。
- 肝硬化 /
- 急性食管胃静脉曲张出血 /
- 出血 /
- 内窥镜检查，胃肠道
Abstract: Acute esophagogastric variceal bleeding （AEGVB） is one of the life-threatening complications of decompensated cirrhosis. Endoscopy is the main method for the diagnosis and treatment of AEGVB， and endoscopic treatment can effectively control acute bleeding and alleviate or eliminate varices. However， there is still a lack of consistent recommendations for the timing of endoscopic examination and intervention for AEGVB in related guidelines in China and globally. Existing studies in China and globally have low quality of evidence， with significant variations in the definition of “early endoscopy” and inconsistent conclusions. This article reviews the research advances in the timing of endoscopic treatment for AEGVB in liver cirrhosis， points out the controversies over the optimal timing of treatment， and discusses future research directions in this field.
- Liver Cirrhosis /
- Esophageal and Gastric Varices /
- Hemorrhage /
- Endoscopy， Gastrointestinal

HTML全文

注： AEGVB，急性食管胃静脉曲张出血；APASL，亚太肝病学会；AASLD，美国肝病学会；ESGE，欧洲胃肠内镜学会；EASL，欧洲肝病学会；ACG，美国胃肠病学会；Child-Pugh评分，蔡尔德-皮尤评分；MELD，终末期肝病模型。

图 1 肝硬化AEGVB患者内镜治疗时机目前存在的争议与挑战

Figure 1. Current controversies and challenges in the timing of endoscopic therapy for AEGVB in cirrhotic patients

下载: 全尺寸图片幻灯片

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