What types of treatments are available for portal hypertension?

  Cirrhosis is a common disease that causes portal hypertension. Prevention and treatment of portal hypertension can prevent and improve upper gastrointestinal hemorrhage, ascites and hypersplenism.       There are several methods of treatment for portal hypertension: 1. Surgery: The common surgical methods used to treat portal hypertension include dissection and shunt, which can be more effective in preventing and treating upper gastrointestinal bleeding caused by portal hypertension. Flow dissection is to cut off the high pressure blood flow to the esophagus, so that the pressure in the vessels of the esophagus drops, thus preventing bleeding from ruptured varices at the lower end of the esophagus. This procedure often involves cutting off the spleen at the same time, which reduces the blood flow to the portal vein and treats hypersplenism with less harm to the patient, with the possibility of improved liver function and generally no hepatic coma. However, the disconnection is not complete and some patients will rebleed. A shunt is a procedure that artificially creates another channel for the high-pressure portal vein, allowing some of the blood in the portal vein to pass through this shunt and flow back to the heart, while less blood flows through the stomach and esophagus, medically known as a portal shunt. This method is good for reducing portal vein pressure, preventing bleeding and eliminating ascites. But the operation is more complicated and dangerous.  2.Scleroembolization therapy: Transendoscopic scleroembolization therapy is to inject sclerosing agent inside or next to the varices in the lower esophagus to occlude the varices, similar to the cut-off surgery. Another new treatment is endoscopic ligation of the varices of the esophagus with a rubber band to occlude the varices and interrupt the blood flow, which is called transendoscopic esophageal variceal ligation. These two procedures are less painful for patients, and the effect of hemostasis has been confirmed, even for patients who cannot do major surgery, most of them can tolerate these two surgical treatments. However, it is often necessary to make several sclerotic embolization or vein ligation to effectively prevent and control bleeding.  3.Pharmacologic therapy: Cardiotrope (also called Protiolol), tablets, 10 mg per tablet, 10-20 mg per oral dose, 2-3 times a day, for life. It is usually started in small doses to reduce the heart rate by 25% of the original heart rate. If the original basal heart rate is 80 beats per minute, it should be reduced to 60 beats per minute after taking the drug. Side effects: It can cause dizziness, slow heartbeat, shortness of breath, and even asthma attack. It cannot be used in patients with asthma, chronic bronchitis (old slow-onset bronchitis) and diabetes.  Posterior pituitary hormone, this drug has a strong vasoconstrictive effect on the internal blood vessels, causing a significant reduction in portal blood flow and a consequent reduction in blood flow into the esophageal and gastric fundic varices, thus treating upper gastrointestinal bleeding. Since this drug is only available as an intravenous injection and not as an oral tablet, its duration of action is short. In clinical practice, two drugs or methods are often used in combination to prevent and control upper gastrointestinal bleeding in portal hypertension, such as the combination of Tuzinan and Rejuvenin, and the combination of posterior pituitary hormone and cardioplegia.