Acute variceal bleeding (AVB) continues to be a fatal complications of cirrhotic portal hypertension. Although the hospitalization rate of patients with acute variceal bleeding has significantly decreased with the advancement of medical technology, and the mortality rate has dropped from 50% three decades before to 15%～20% now, the in-hospital mortality rate is still high and is closely related to the severity of cirrhosis, ranging from 0 in Child A grade to 32% in Child C grade. Therefore, it is a good choice to risk stratify these patients and individualize the treatment method according to the expected risk, as the risk of death in patients with acute variceal bleeding is highly heterogeneous. This article mainly reviews the current status of risk stratification and treatment of acute variceal bleeding in cirrhosis.
急性食管胃静脉曲张破裂出血仍然是肝硬化门静脉高压致命性的并发症。虽然随着医疗技术的进步，急性曲张静脉出血患者的住院率已经明显下降，病死率已由30年前的50%降低到了现在的15%～20%，但是，住院病死率仍然很高，并且与肝硬化的严重程度密切相关，从Child-Pugh A级的0到Child-Pugh C级的32%不等。由于急性静脉曲张出血患者死亡风险异质性较大，对这些患者进行危险分层并根据预期风险进行个体化治疗是较好的选择。该文主要就目前肝硬化急性静脉曲张出血的危险分层及治疗的现状进行综述。.