肝硬化食管胃静脉曲张的内镜治疗

肝硬化食管胃静脉曲张出血是危及生命的门脉高压并发症。食管静脉曲张一级预防策略为非选择性β受体阻滞剂（non selective beta blockers，NSBBs）或内镜下静脉曲张套扎术（endoscopic variceal ligation，EVL），急性出血时首选EVL，其二级预防推荐NSBBs联合EVL。胃静脉曲张出血中，食管胃静脉曲张1型（gastroesophageal varices type 1，GOV1）应用EVL，食管胃静脉曲张2型（gastroesophageal varices type 2，GOV2）和孤立胃静脉曲张（isolated gastric varices，IGV）推荐内镜下组织胶注射术。预防胃静脉曲张再出血方面，内镜下组织胶注射术和经颈静脉肝内门体分流术（transjugular intrahepatic portosystemic shunt，TIPS）可应用于GOV2型和IGV，EVL、NSBBs或内镜下组织胶注射术可应用于GOV1型。胃静脉曲张一级预防可选用NSBBs或内镜下组织胶注射术。

Endoscopic treatment of esophagogastric varices in cirrhosis

Variceal bleeding in cirrhosis is a life threatening complication of portal hypertension. The primary prophylaxis strategy of esophageal varices is non selective beta blockers (NSBBs) or endoscopic variceal ligation (EVL). EVL is the first choice for acute esophageal varices bleeding. The combination of NSBBs and EVL is the recommended management in the secondary prophylaxis. For gastric varices bleeding, gastroesophageal varices type 1 (GOV1) is recommended for EVL, gastroesophageal varices type 2 (GOV2) and isolated gastric varices (IGV) are recommended for endoscopic tissue glue injection. In the prevention of gastric varices rebleeding, transjugular intrahepatic portosystemic shunt (TIPS) can be applied to GOV2 and IGV, and EVL, NSBBs or endoscopic tissue glue injection can be applied to GOV1. NSBBs or endoscopic tissue glue injection can be used for primary prophylaxis of gastric varices.