食道靜脈曲張之治療及護理

Management and Nursing Care for Patient with Esophageal Varices

食道靜脈曲張破裂出血，是最主要威脅到肝硬化病患生命的合併症，大約有40％～70％的肝硬化患者，會發生食道靜脈曲張，其中大約有40％會發生出血的危險性，所導致的死亡率更高達30％～50％，故預防及治療食道靜脈曲張破裂出血，所導致的低血容積休克是很重要的。目前醫療處置包括有藥物治療、內視鏡治療、氣球填塞法、門脈系統分流術及經頸靜脈肝內門脈系統分流術等。針對不同的治療方法護理人員應提供適切的護理措施。

Hemorrhage from esophageal varices is a major life threatening complication of liver cirrhosis. About 40%~70% of liver cirrhosis patients develop esophageal varices, among whom about 40% have clinical hemorrhage. Variceal bleeding usually carries a mortality rate ranging between 30% and 50%. Hemorrhage from esophageal varices may induce hypovolemic shock, therefore, it is very important to prevent and treat the ruptured esophageal varices bleeding. Medical management of variceal bleeding includes medicine, endoscopic treatment, balloon tamponade, portal systemic shunt, and transjugular intrahepatic portal system stent shunt (TIPS). Proper nursing intervention should be provided to patients receiving different treatments.