Portal hypertension variceal hemorrhage treatment of.doc

 PAGE \* MERGEFORMAT 34 Portal hypertension variceal hemorrhage treatment of Keywords: cirrhosis; Hypertension, portal; esophageal and gastric varices; bleeding; drug therapy; surgery Esophageal variceal bleeding (EGVB) is a cirrhotic portal hypertension of the most serious complications. In patients with liver cirrhosis, 40% develop esophageal varices, while in patients with esophageal varices about 50% ~ 60% concurrent haemorrhage, the salient features of its large amount of bleeding that sets rapidly and dangerous illness, died rate of up to 40% or more, if not promptly treated, patients can occur due to acute hemorrhage shock and cause serious consequences. EGVB right at home and abroad has long been the treatment of liver cirrhosis with portal hypertension, one of the main objectives and contents, its meaning is particularly important. At present, the main treatment methods include medical drug therapy, surgical treatment, endoscopic treatment and interventional therapy and so on. I now present a range of treatment methods, as well as in the treatment of EGVB achieved some progress are summarized below. 1 EGVB drug treatment The main purpose of drug treatment EGVB through the role of drugs to reduce portal vein and varicose vein pressure, thereby reducing the tension of varicose veins of the blood vessel wall to achieve hemostasis therapeutic effect. The ideal drug should have the following characteristics [1]: ① are valid for all EGVB; ② No contraindications and side effects; ③ do not need medical treatment for a special guardianship; ④ good oral absorption for long-term treatment; ⑤ key is not in the liver metabolism or biliary excretion, and thus will not be affected due to liver disease, the dose of drugs. There is no one drug can reach all of the above requirements. 1.1 vasopressin and its derivatives 1.1.1 vasopressin (VP) VP can be directly contracted visceral vascular bed of small arteries and precapi