Gu C, Song M Y, Sun W J, Xu X Y, Yang C Q, Chen D F
Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China.
Department of Gastroenterology, Tongji Hospital, Tongji University of Medicine, Shanghai 200065, China.
Zhonghua Gan Zang Bing Za Zhi. 2017 Jan 20;25(1):5-8. doi: 10.3760/cma.j.issn.1007-3418.2017.01.003.
Esophageal and gastric varices are common complications of liver cirrhosis and are seen in 50% of patients with liver cirrhosis. The annual incidence rate of esophagogastric variceal bleeding is 5%-15%, and even if the recommended treatment is used, the 6-week mortality rate is still as high as 15%-20%. Spontaneous bacterial peritonitis (SBP) is a common complication of end-stage liver disease and has an incidence rate of 10%-30% in patients with severe liver damage. SBP refers to the bacterial infection of the peritoneum and/or ascites that occurs in the absence of any inflammation in adjacent tissues (e.g., intestinal perforation and intestinal abscess). Hepatic encephalopathy (HE) is the clinical syndrome manifesting as cognitive impairment in patients with chronic liver disease, and its pathogenesis has not yet been fully elucidated and may be associated with ammonia poisoning theory, γ-aminobutyric acid and endogenous benzodiazepine complex receptor theory, and inflammatory pathway theory. This article introduces the advances in the treatment of upper gastrointestinal bleeding in patients with liver cirrhosis, SBP, and HE in 2016.
食管和胃静脉曲张是肝硬化的常见并发症,见于50%的肝硬化患者。食管胃静脉曲张出血的年发生率为5%-15%,即使采用推荐的治疗方法,6周死亡率仍高达15%-20%。自发性细菌性腹膜炎(SBP)是终末期肝病的常见并发症,在严重肝损伤患者中的发生率为10%-30%。SBP是指在相邻组织无任何炎症(如肠穿孔和肠脓肿)的情况下发生的腹膜和/或腹水的细菌感染。肝性脑病(HE)是慢性肝病患者表现为认知障碍的临床综合征,其发病机制尚未完全阐明,可能与氨中毒学说、γ-氨基丁酸与内源性苯二氮䓬复合物受体学说以及炎症通路学说有关。本文介绍了2016年肝硬化、SBP和HE患者上消化道出血治疗的进展。