Year: 2025
Type: article
Abstract: 目的：系统梳理肝硬化并发胃静脉曲张内镜治疗的技术演进与循证进展，为优化治疗决策及创新技术转化提供理论依据。方法：查阅国内外与肝硬化并发胃静脉曲张内镜下治疗相关的研究文献，分析总结当前临床治疗中常见及最新的胃静脉曲张内镜下治疗技术进展。结果：传统内镜下硬化剂治疗虽操作便捷，但存在再出血率高、需重复治疗等局限。组织胶注射术目前仍是治疗胃静脉曲张的主流选择。超声内镜引导下弹簧圈联合组织胶注射治疗在减少胶体用量、控制异位栓塞等方面展现出独特优势，具有良好的安全性和有效性。内镜下组织胶注射联合介入治疗的改良策略也被多项研究认为能够进一步优化疗效，降低不良反应风险。结论：肝硬化胃静脉曲张的内镜下治疗已进入精准化、联合化新时代。通过技术创新与临床证据的持续积累，胃静脉曲张内镜下治疗将朝着更高安全性、更低复发率的目标稳步迈进。Objective: To systematically review the technological evolution and evidence-based progress of endoscopic treatment for gastric varices secondary to cirrhosis, providing a theoretical basis for optimizing treatment strategies and facilitating technological innovation. Methods: Relevant studies on endoscopic treatment of gastric varices in cirrhotic patients were reviewed from both domestic and international literature. The advancements in commonly used and emerging endoscopic techniques for gastric varices were analyzed and summarized. Results: Although traditional endoscopic sclerotherapy is easy to perform, it has limitations such as a high rebleeding rate and the need for repeated interventions. Cyanoacrylate injection remains the mainstream treatment for gastric varices. Endoscopic ultrasound (EUS)-guided coil embolization combined with cyanoacrylate injection has demonstrated unique advantages in reducing cyanoacrylate dosage and preventing ectopic embolization, offering favorable safety and efficacy. Furthermore, modified strategies integrating endoscopic cyanoacrylate injection with interventional therapy have been recognized by multiple studies as a means to further optimize therapeutic outcomes and reduce adverse events. Conclusion: Endoscopic treatment of gastric varices in cirrhosis has entered a new era of precision and combination therapy. With ongoing technological innovation and the accumulation of clinical evidence, endoscopic treatment of gastric varices is steadily progressing toward greater safety and lower recurrence rates.
Source: Advances in Clinical Medicine
Author: 之琪 刘
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4409113928