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胃食管静脉曲张的预防和处理。

Prevention and management of gastroesophageal varices.

机构信息

Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

出版信息

Clin Mol Hepatol. 2018 Mar;24(1):20-42. doi: 10.3350/cmh.2017.0064. Epub 2017 Dec 18.

DOI:10.3350/cmh.2017.0064
PMID:29249128
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5875194/
Abstract

Bleeding from gastroesophageal varices is a serious complication in patients with liver cirrhosis and portal hypertension. Although there has been significance improvement in the prognosis of variceal bleeding with advancement in diagnostic and therapeutic modalities for its management, mortality rate still remains high. Therefore, appropriate prevention and rapid, effective management of bleeding from gastroesophageal varices is very important. Recently, various studies about management of gastoesophageal varices, including prevention of development and aggravation of varices, prevention of first variceal bleeding, management of acute variceal bleeding, and prevention of variceal rebleeding, have been published. The present article reviews published articles and practice guidelines to present the most optimal management of patients with gastroesophageal varices.

摘要

胃食管静脉曲张出血是肝硬化和门静脉高压患者的严重并发症。尽管随着诊断和治疗方法的进步,静脉曲张出血的预后有了显著改善,但死亡率仍然很高。因此,适当的预防和快速、有效的胃食管静脉曲张出血管理非常重要。最近,关于胃食管静脉曲张的各种管理研究,包括预防静脉曲张的发展和加重、预防首次静脉曲张出血、急性静脉曲张出血的管理以及预防静脉曲张再出血,已经发表。本文综述了已发表的文章和实践指南,以提供胃食管静脉曲张患者的最佳管理方案。

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Prevention and management of gastroesophageal varices.胃食管静脉曲张的预防和处理。
Clin Mol Hepatol. 2018 Mar;24(1):20-42. doi: 10.3350/cmh.2017.0064. Epub 2017 Dec 18.
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Prognostic model for esophagogastric variceal rebleeding after endoscopic treatment in liver cirrhosis: A Chinese multicenter study.肝硬化患者内镜治疗后食管胃静脉曲张再出血的预后模型:一项中国多中心研究。
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本文引用的文献

1
Recent advances in the management of variceal bleeding.静脉曲张出血管理的最新进展
Gastroenterol Rep (Oxf). 2017 May;5(2):113-126. doi: 10.1093/gastro/gox007. Epub 2017 Apr 7.
2
Multicenter External Validation of Risk Stratification Criteria for Patients With Variceal Bleeding.多中心验证静脉曲张出血患者风险分层标准。
Clin Gastroenterol Hepatol. 2018 Jan;16(1):132-139.e8. doi: 10.1016/j.cgh.2017.04.042. Epub 2017 May 10.
3
Changes in Cardiac Varices and Their Clinical Significance after Eradication of Esophageal Varices by Band Ligation.结扎治疗食管静脉曲张后心脏静脉曲张的变化及其临床意义。
Can J Gastroenterol Hepatol. 2016;2016:2198163. doi: 10.1155/2016/2198163. Epub 2016 Dec 26.
4
Cyanoacrylate injection versus band ligation for bleeding from cardiac varices along the lesser curvature of the stomach.氰基丙烯酸酯注射与胃小弯侧心脏静脉曲张出血的套扎术对比
Clin Mol Hepatol. 2016 Dec;22(4):487-494. doi: 10.3350/cmh.2016.0050. Epub 2016 Dec 25.
5
Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases.肝硬化门静脉高压出血:风险分层、诊断及管理:美国肝病研究协会2016年实践指南
Hepatology. 2017 Jan;65(1):310-335. doi: 10.1002/hep.28906. Epub 2016 Dec 1.
6
Carvedilol delays the progression of small oesophageal varices in patients with cirrhosis: a randomised placebo-controlled trial.卡维地洛延迟肝硬化患者小食管静脉曲张的进展:一项随机安慰剂对照试验。
Gut. 2017 Oct;66(10):1838-1843. doi: 10.1136/gutjnl-2016-311735. Epub 2016 Jun 13.
7
Addition of Simvastatin to Standard Therapy for the Prevention of Variceal Rebleeding Does Not Reduce Rebleeding but Increases Survival in Patients With Cirrhosis.辛伐他汀联合标准疗法预防静脉曲张再出血不能降低再出血率,但可提高肝硬化患者生存率。
Gastroenterology. 2016 May;150(5):1160-1170.e3. doi: 10.1053/j.gastro.2016.01.004. Epub 2016 Jan 14.
8
Comparison of Balloon-Occluded Retrograde Transvenous Obliteration (BRTO) Using Ethanolamine Oleate (EO), BRTO Using Sodium Tetradecyl Sulfate (STS) Foam and Vascular Plug-Assisted Retrograde Transvenous Obliteration (PARTO).使用油酸乙醇胺(EO)的球囊闭塞逆行静脉闭塞术(BRTO)、使用十四烷基硫酸钠(STS)泡沫的BRTO以及血管栓塞辅助逆行静脉闭塞术(PARTO)的比较
Cardiovasc Intervent Radiol. 2016 Jun;39(6):840-6. doi: 10.1007/s00270-015-1288-8. Epub 2016 Jan 12.
9
Esophageal balloon tamponade versus esophageal stent in controlling acute refractory variceal bleeding: A multicenter randomized, controlled trial.食管球囊填塞与食管支架治疗急性难治性静脉曲张出血的多中心随机对照研究。
Hepatology. 2016 Jun;63(6):1957-67. doi: 10.1002/hep.28360. Epub 2016 Jan 14.
10
Cyanoacrylate Injection Versus Band Ligation in the Endoscopic Management of Acute Gastric Variceal Bleeding: Meta-Analysis of Randomized, Controlled Studies Based on the PRISMA Statement.内镜下治疗急性胃静脉曲张出血时氰基丙烯酸酯注射与套扎术的比较:基于PRISMA声明的随机对照研究的Meta分析
Medicine (Baltimore). 2015 Oct;94(41):e1725. doi: 10.1097/MD.0000000000001725.