Ilyas Jawad A, Kanwal Fasiha
Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, 6620 Main St., Houston, TX 77030, USA.
Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, 6620 Main St., Houston, TX 77030, USA; Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
Gastroenterol Clin North Am. 2014 Dec;43(4):783-94. doi: 10.1016/j.gtc.2014.08.008. Epub 2014 Sep 22.
Gastroesophageal varices are present in almost half of patients with cirrhosis at the time of initial diagnosis. Variceal bleeding occurs in 25% to 35% of patients with cirrhosis. Effective and timely care can prevent variceal bleeding (primary prophylaxis). For example, clinical studies demonstrate that both beta-blockers and endoscopic variceal ligation are effective in preventing a first episode of variceal bleeding. The major challenge is to screen patients in a timely manner and institute a form of therapy that has the highest chance of success in terms of patient compliance and effectiveness.
在肝硬化患者初次诊断时，近半数患者存在胃食管静脉曲张。25%至35%的肝硬化患者会发生静脉曲张出血。有效且及时的治疗可预防静脉曲张出血（一级预防）。例如，临床研究表明，β受体阻滞剂和内镜下静脉曲张结扎术在预防首次静脉曲张出血方面均有效。主要挑战在于及时筛查患者，并制定一种在患者依从性和有效性方面成功率最高的治疗方式。
