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目的评估ＥＶＳ、ＥＶＬ、组织粘合剂注射及ＴＩＰＳＳ治疗门静脉高压食管胃静脉曲张出血的优缺点。方法对７１２例食管胃静脉曲张出血病人进行了回顾分析。结果ＥＶＳ６１５例，经１８２６次治疗，急诊止血率为９６．９％，食管静脉曲张消失率为８４．６％，并发症发生率为１４．７％，肝硬化患者３４４人随访１２～１０４月，１、３、５年生存率为９１．５２％±１．３６％．７１．４２％２１．７１、４７．１３％±１．８６％。ＥＶＬ３０例，食管静脉消失率为７６．７％，复发出血１３．３％。组织粘合剂注射１２例，急诊６例全部止血。ＴＩＰＳＳ治疗先例。成功率为９０．９％食管静脉曲张消失和好转为８２．３％并发症发生率为３６％。一年内支架闭塞、狭窄、复发出血１６例（３８．０９％），随访１２～４２月，死亡１２人（２１．８％）。结论内镜下介入治疗是食管静脉曲张出血首选方法。急诊止血以ＥＶＳ和内镜下组织粘合剂注射为优，ＥＶＬ浸润性并发症低，但反复出血率较高，ＴＩＰＳＳ治疗中远期疗效不佳。
Objective To evaluate the advantages and disadvantages of EVS, EVL, tissue adhesive injection and TIPSS for the treatment of portal hypertension and portal hypertension. Methods 712 cases of esophagogastric variceal bleeding were retrospectively analyzed. Results EVS615 cases were treated 1818 times, the emergency bleeding rate was 96.9%, the disappearance rate of esophageal varices was 84.6%, the complication rate was 14.7%, 344 patients with cirrhosis were followed up for 12 ~ 104 months, The 1, 3, 5-year survival rates were 91.52% ± 1.36%. 71.42% 21.71, 47.13% ± 1.86%. EVL30 cases, esophageal vein disappearance rate of 76.7%, recurrent hemorrhage 13.3%. Tissue adhesive injection in 12 cases, emergency 6 cases all stop bleeding. TIPSS treatment precedent. The success rate was 90.9% disappearance and improvement of esophageal varices 82.3% complication rate was 36%. Within one year, there were 16 cases (38.09%) with occlusion, stenosis and recurrent hemorrhage. Twelve (21.8%) were followed up from December to April. Conclusion Endoscopic intervention is the preferred method of esophageal variceal bleeding. Emergency hemostasis with EVS and endoscopic tissue adhesive injection is superior, EVL invasive complications are low, but the high rate of repeated bleeding, TIPSS treatment of poor long-term efficacy.