CAJ | 학술논문

肝硬化共同的病理生理改变是肝功能损害和门静脉高压症,后者引起的上消化道出血是肝硬化患者最主要的死亡原因.因此,预防和控制食管胃底静脉曲张破裂出血是门静脉高压症主要的治疗目的.但无论是药物治疗还是内镜治疗、断流术还是分流术,都不能完全解决门静脉高压症引起的上消化道出血.虽然肝移植是最佳治疗手段,由于供肝、医疗条件等所限,断流术仍是我国比较可靠的防止门静脉高压症食管胃底静脉曲张破裂出血的手段,而对于手术适应证、手术时机以及术式选择等存在争议.
간경화공동적병리생리개변시간공능손해화문정맥고압증,후자인기적상소화도출혈시간경화환자최주요적사망원인.인차,예방화공제식관위저정맥곡장파렬출혈시문정맥고압증주요적치료목적.단무론시약물치료환시내경치료、단류술환시분류술,도불능완전해결문정맥고압증인기적상소화도출혈.수연간이식시최가치료수단,유우공간、의료조건등소한,단류술잉시아국비교가고적방지문정맥고압증식관위저정맥곡장파렬출혈적수단,이대우수술괄응증、수술시궤이급술식선택등존재쟁의.
A common pathophysiological changes caused by liver cirrhosis indudes damage of liver function and portal hypertension,and upper gastrointestinal hemorrhage caused by portal hypertension is the main cause of death in patients with liver cirrhosis.Therefore,the main purpose of portal hypertension treatment should be prevention and control of esophagus and fundus of stomach variceal bleeding.However,upper gastrointestinal bleeding can not be completely cured no matter by medication or endoscopic treatment,devascularization or shunt.Although liver transplantation is the best treatment method for portal hypertension,the application of liver transplantation is limited by the source of donor and medical condition.Devascularization is effective to treat upper gastrointestinal hemorrhage caused by portal hypertension,while disputes exist on the surgical indications,timing and procedure selection.