门静脉高压症胃胃病和胃血管扩张症的治疗。
Management of gastropathy and gastric vascular ectasia in portal hypertension.
机构信息
Department of Digestive Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
出版信息
Clin Liver Dis. 2010 May;14(2):281-95. doi: 10.1016/j.cld.2010.03.013.
Abstract
Portal hypertensive gastropathy and gastric antral vascular ectasia may cause gastrointestinal hemorrhage in patients with portal hypertension. Whereas the former presents exclusively in patients with portal hypertension, gastric antral vascular ectasia can also be observed in patients with other conditions. Diagnosis is established with upper gastrointestinal endoscopy, although some cases may require a biopsy to confirm the diagnosis. The most frequent manifestation is ferropenic anemia, which may become transfusion dependent. Treatment in portal hypertensive gastropathy is focused on portal pressure reducing drugs, mainly nonselective beta-blockers, whereas in gastric antral vascular ectasia treatment is based on endoscopic ablation. More invasive options can be used if first-line therapies fail, although these should be evaluated on a case-by-case basis.
摘要
门脉高压性胃病和胃底静脉曲张可能导致门脉高压患者发生胃肠道出血。前者仅见于门脉高压患者，而胃底静脉曲张也可见于其他疾病患者。诊断方法为上消化道内镜检查，但某些情况下可能需要活检来确诊。最常见的表现是缺铁性贫血，可能需要输血。门脉高压性胃病的治疗侧重于降低门脉压的药物，主要是非选择性β受体阻滞剂，而胃底静脉曲张的治疗则基于内镜消融。如果一线治疗失败，可以使用更具侵袭性的治疗方法，但应根据具体情况进行评估。
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本文引用的文献
1
Endoscopic band ligation for the treatment of gastric antral vascular ectasia.
Gastrointest Endosc. 2009 May;69(6):1194. doi: 10.1016/j.gie.2008.09.018.
2
Endoscopic argon plasma coagulation for the treatment of gastric antral vascular ectasia-related bleeding in patients with liver cirrhosis.
Digestion. 2009;79(3):143-50. doi: 10.1159/000210087. Epub 2009 Mar 30.
3
Veins around the esophagus and the stomach: do their calibrations provide a diagnostic clue for portal hypertensive gastropathy?
Clin Imaging. 2009 Jan-Feb;33(1):22-4. doi: 10.1016/j.clinimag.2008.06.023.
4
Significance of ERK nitration in portal hypertensive gastropathy and its therapeutic implications.
Am J Physiol Gastrointest Liver Physiol. 2008 Nov;295(5):G1016-24. doi: 10.1152/ajpgi.90329.2008. Epub 2008 Sep 11.
5
Endoscopic cryotherapy for the management of gastric antral vascular ectasia.
Gastrointest Endosc. 2008 Nov;68(5):895-902. doi: 10.1016/j.gie.2008.03.1109. Epub 2008 Jul 21.
6
Gastric antral vascular ectasia (GAVE) associated with systemic sclerosis.
Scand J Rheumatol. 2008 Jul-Aug;37(4):315-6. doi: 10.1080/03009740801998754.
7
Characteristic endoscopic features of portal hypertensive enteropathy.
J Gastroenterol. 2008;43(5):327-31. doi: 10.1007/s00535-008-2166-9. Epub 2008 Jul 1.
8
Treatment of gastric antral vascular ectasia (watermelon stomach) with endoscopic band ligation.
Gastrointest Endosc. 2008 Aug;68(2):231-6. doi: 10.1016/j.gie.2008.02.021. Epub 2008 Jun 3.
9
Capsule endoscopy in the investigation of patients with portal hypertension and anemia.
Can J Gastroenterol. 2008 May;22(5):469-74. doi: 10.1155/2008/534871.
10
Esophageal capsule endoscopy for screening and surveillance of esophageal varices in patients with portal hypertension.
Hepatology. 2008 May;47(5):1595-603. doi: 10.1002/hep.22227.
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