CAJ | 학술논문

肝硬化食管胃底静脉曲张出血应采用个体化、规范化的综合治疗。临床疑为曲张静脉出血，应首选血管活性药物、抗生素和内镜联合治疗。三腔二囊管压迫和药物联合治疗可用于无条件开展内镜治疗的病例。药物和内镜难以控制的出血，可选用 TIPS。若非手术治疗失败或无条件开展 TIPS 等技术，手术治疗具有不可替代的作用，包括断流、分流或断流加分流术，应根据不同个体的不同病情加以应用，以减少并发症、降低手术死亡率。合并慢性病毒性肝炎者，应酌情给与抗病毒治疗。
간경화식관위저정맥곡장출혈응채용개체화、규범화적종합치료。림상의위곡장정맥출혈，응수선혈관활성약물、항생소화내경연합치료。삼강이낭관압박화약물연합치료가용우무조건개전내경치료적병례。약물화내경난이공제적출혈，가선용 TIPS。약비수술치료실패혹무조건개전 TIPS 등기술，수술치료구유불가체대적작용，포괄단류、분류혹단류가분류술，응근거불동개체적불동병정가이응용，이감소병발증、강저수술사망솔。합병만성병독성간염자，응작정급여항병독치료。
The treatment of acute variceal hemorrhage in patients with liver cirrhosis should be individualized,standardized and comprehensive.If variceal hemorrhage is suspected,a combined regi-men of vasoactive drug,antibiotic and endoscopic variceal ligation should be the first-line therapy. Balloon tamponade plus vasoactive agents may be employed when endoscopic management is unavaila-ble.Transjugular intrahepatic portal-systemic shunt (TIPS)offers an option for refractory hemor-rhage.Surgical procedures including devascularization,shunt or devascularization plus shunt play irre-placeable roles when non-surgical management is unsuccessful and TIPS is unavailable.For reducing the complication and mortality,a selection of surgical procedure should be dependent on different indi-vidual conditions.For cirrohotic patients with chronical viral hepatitis,antiviral therapy should be of-fered.