Cárdenas Andrés, Baiges Anna, Hernandez-Gea Virginia, Garcia-Pagan Juan Carlos
GI/Endoscopy Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi-Sunyer (IDIBAPS), Ciber de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain.
Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi-Sunyer (IDIBAPS), Ciber de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain.
Gastroenterol Clin North Am. 2014 Dec;43(4):795-806. doi: 10.1016/j.gtc.2014.08.009. Epub 2014 Sep 29.
Acute variceal bleeding (AVB) is a milestone event for patients with portal hypertension. Esophageal varices bleed because of an increase in portal pressure that causes the variceal wall to rupture. AVB in a patient with cirrhosis and portal hypertension is associated with significant morbidity and mortality. The initial management of these patients includes proper resuscitation, antibiotic prophylaxis, pharmacologic therapy with vasoconstrictors, and endoscopic therapy. Intravascular fluid management, timing of endoscopy, and endoscopic technique are key in managing these patients. This article reviews the current endoscopic hemostatic strategies for patients with AVB.
急性静脉曲张出血（AVB）是门静脉高压患者的一个关键事件。食管静脉曲张出血是由于门静脉压力升高导致曲张静脉壁破裂所致。肝硬化和门静脉高压患者的AVB与显著的发病率和死亡率相关。这些患者的初始治疗包括适当的复苏、抗生素预防、使用血管收缩剂的药物治疗以及内镜治疗。血管内液体管理、内镜检查的时机和内镜技术是管理这些患者的关键。本文综述了目前针对AVB患者的内镜止血策略。
