胃静脉曲张患者的管理
Management of Patients With Gastric Varices.
作者信息
Calmet Fernando, Mohan Prasoon, Jalaeian Hamed, Martin Paul
机构信息
Department of Medicine, Division of Gastroenterology, Newton-Wellesley Hospital, Newton, Massachusetts.
Department of Medicine, Division of Gastroenterology, Tufts University School of Medicine, Boston, Massachusetts.
出版信息
Gastroenterol Hepatol (N Y). 2022 Oct;18(10):574-585.
Management of patients with gastric varices represents a unique challenge for clinicians. The broad range of endoscopic and endovascular techniques currently available is in stark contrast with the limited evidence available to inform the optimal management of these patients. This article describes the classification, pathophysiology, and natural history of gastric varices; summarizes the available evidence regarding medical, endoscopic, and endovascular management of gastric varices; and provides recommendations on how to integrate these options. Management of these patients ultimately requires a multidisciplinary approach involving hepatologists, therapeutic endoscopists, and interventional radiologists, with consideration given to patient characteristics and local expertise.
胃静脉曲张患者的管理对临床医生而言是一项独特的挑战。目前可用的内镜和血管内技术种类繁多，这与用于指导这些患者最佳管理的有限证据形成了鲜明对比。本文描述了胃静脉曲张的分类、病理生理学和自然病史；总结了关于胃静脉曲张的药物、内镜和血管内管理的现有证据；并就如何整合这些选择提供了建议。对这些患者的管理最终需要多学科方法，涉及肝病学家、治疗内镜医师和介入放射科医生，并要考虑患者特征和当地专业知识。
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