Gastroenterología, Hospital Universitario Ramón y Cajal, España.
Gastroenterología y Hepatología, Hospital Universitario Ramón y Cajal.
Rev Esp Enferm Dig. 2022 Sep;114(9):534-542. doi: 10.17235/reed.2022.8868/2022.
Development of portal hypertension is the most critical hallmark in the natural history of advanced chronic liver disease, as it is responsible for most liver decompensations. Correct risk stratification allows the design of personalized treatment strategies. In addition, the dynamic nature of chronic liver disease requires a refinement of both invasive and non-invasive diagnostic methods at every stage. Treatment with non-selective beta blockers and suppression of the etiologic factor improve portal hypertension and decrease the probability of decompensation in high-risk patients. Patients admitted for variceal hemorrhage also benefit from personalized management, where insertion of a preventive TIPS plays a relevant role.
门静脉高压症的发展是晚期慢性肝病自然史中最关键的标志，因为它是大多数肝功能失代偿的原因。正确的风险分层可以设计个性化的治疗策略。此外，慢性肝病的动态性质要求在每个阶段都对侵入性和非侵入性诊断方法进行细化。非选择性β受体阻滞剂治疗和病因抑制可改善门静脉高压，降低高危患者发生失代偿的概率。因食管胃静脉曲张出血入院的患者也受益于个性化管理，预防性 TIPS 置入在此发挥着重要作用。
