Kumar Sumit, Asrani Sumeet K, Kamath Patrick S
Department of Internal Medicine, Abington Memorial Hospital, 1200 Old York Road, Abington, PA 19001, USA.
Baylor University Medical Center, 3410 Worth Street, Suite 860, Dallas, TX 75246, USA.
Gastroenterol Clin North Am. 2014 Dec;43(4):765-82. doi: 10.1016/j.gtc.2014.08.007. Epub 2014 Oct 3.
Acute variceal bleeding (AVB) is a potentially life-threatening complication of cirrhosis and portal hypertension. Combination therapy with vasoactive drugs and endoscopic variceal ligation is the first-line treatment in the management of AVB after adequate hemodynamic resuscitation. Short-term antibiotic prophylaxis, early resuscitation, early use of lactulose for prevention of hepatic encephalopathy, targeting of conservative goals for blood transfusion, and application of early transjugular intrahepatic portosystemic shunts in patients with AVB have further improved the prognosis of AVB. This article discusses the epidemiology, diagnosis, and nonendoscopic management of AVB.
急性静脉曲张出血（AVB）是肝硬化和门静脉高压症的一种潜在危及生命的并发症。在充分的血流动力学复苏后，血管活性药物与内镜下静脉曲张结扎术联合治疗是AVB管理中的一线治疗方法。短期抗生素预防、早期复苏、早期使用乳果糖预防肝性脑病、针对输血的保守目标以及对AVB患者应用早期经颈静脉肝内门体分流术进一步改善了AVB的预后。本文讨论了AVB的流行病学、诊断和非内镜管理。
