肝硬化食管静脉曲张出血的一级预防
Primary prophylaxis of bleeding from esophageal varices in cirrhosis.
作者信息
Merkel Carlo, Montagnese Sara, Amodio Piero
机构信息
Department of Medicine DIMED, University of Padua, Via Giustiniani, 2, I-35126 Padova, Italy.
出版信息
J Clin Exp Hepatol. 2013 Sep;3(3):198-203. doi: 10.1016/j.jceh.2013.08.002. Epub 2013 Sep 7.
Prophylaxis of the first bleeding from esophageal varices became a clinical option more than 20 years ago, and gained a large diffusion in the following years. It is based on the use of nonselective beta-blockers, which decreases portal pressure, or on the eradication of esophageal varices by endoscopic band ligation of varices. In patients with medium or large varices either of these treatments is indicated. In patients with small varices only medical treatment is feasible, and in patients with medium and large varices with contraindication or side-effects due to beta-blockers, only endoscopic band ligation may be used. In this review the rationale and the results of the prophylaxis of bleeding from esophageal varices are discussed.
20多年前，预防食管静脉曲张首次出血就已成为一种临床选择，并在随后几年得到广泛应用。其方法基于使用可降低门静脉压力的非选择性β受体阻滞剂，或通过内镜下对静脉曲张进行套扎来消除食管静脉曲张。对于中、大型静脉曲张患者，这两种治疗方法均可采用。对于小型静脉曲张患者，仅可行药物治疗；而对于中、大型静脉曲张且因β受体阻滞剂存在禁忌证或副作用的患者，则只能采用内镜下套扎术。本文综述了食管静脉曲张出血预防的理论依据及结果。
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