《2016年美国肝病学会肝硬化门静脉高压出血的风险分层、诊断和管理实践指导》解读

doi:10.12066/j.issn.1007-2861.2002

上海大学学报(自然科学版) ›› 2018, Vol. 24 ›› Issue (3): 336-340.doi: 10.12066/j.issn.1007-2861.2002

《2016年美国肝病学会肝硬化门静脉高压出血的风险分层、诊断和管理实践指导》解读

宋维平, 杨长青()

同济大学附属同济医院消化科, 上海 200065

收稿日期:2018-02-26 出版日期:2018-06-15 发布日期:2018-06-27
通讯作者: 杨长青 E-mail:cqyang@tongji.edu.cn

Interpretation of Portal Hypertensive Bleeding in Cirrhosis: Risk Stratification, Diagnosis and Management: 2016 Practice Guidance by the American Association for the Study of Liver Diseases

SONG Weiping, YANG Changqing()

Department of Gastroenterology, Tongji Hospital of Tongji University, Shanghai 200065, China

Received:2018-02-26 Online:2018-06-15 Published:2018-06-27
Contact: YANG Changqing E-mail:cqyang@tongji.edu.cn

摘要/Abstract

摘要：

由于肝硬化的病程、静脉曲张的解剖位置、合并症等因素的不同,肝硬化门脉高压出血患者需慎重选择诊断、治疗及预防再出血的方法.2016年美国肝病学会根据大量临床研究数据,对该病的诊断、治疗和预防提供了指导意见.通过对该实践指导的解读以及对比中国的实践指南,以期获得药物治疗新亮点, 从而解决与肝脏疾病相关的临床问题.

关键词: 肝硬化, 静脉曲张出血, 诊断, 治疗

Abstract:

Hemorrhage resulting from high pressure of portal vein is a common complication of decompensated liver cirrhosis. Because of different courses, anatomic locations of varicose vein and complications, patients with cirrhosis need to be prudent in their choice of methods for diagnosis, treatment and prevention of rebleeding. Portal Hypertensive Bleeding in Cirrhosis: Risk Stratification, Diagnosis and Management: 2016 Practice Guidance by the American Association for the Study of Liver Diseases, which is based on a great deal of clinical data, may serve as a guideline for clinical practice in China as well. This paper, through close reading of the practice guidance, and through comparative analysis between the American guidance and that in China, hopes to shed some new light for medical practitioners on the handling of various problems connected with liver diseases.

Key words: cirrhosis, varicose bleeding, diagnosis, treatment

中图分类号:

R575.2

宋维平, 杨长青. 《2016年美国肝病学会肝硬化门静脉高压出血的风险分层、诊断和管理实践指导》解读[J]. 上海大学学报(自然科学版), 2018, 24(3): 336-340.

SONG Weiping, YANG Changqing. Interpretation of Portal Hypertensive Bleeding in Cirrhosis: Risk Stratification, Diagnosis and Management: 2016 Practice Guidance by the American Association for the Study of Liver Diseases[J]. Journal of Shanghai University（Natural Science Edition）, 2018, 24(3): 336-340.

参考文献 16

[1]	Groszmann R J, Garcia-Tsao G, Bosch J, et al. Beta-blockers to prevent gastroesophageal varices in patients with cirrhosis[J]. N Engl J Med, 2005,353(21):2254-2261. doi: 10.1056/NEJMoa044456 pmid: 16306522
[2]	De Franchis R, Faculty B V. Expanding consensus in portal hypertension: report of the Baveno VI Consensus workshop: stratifying risk and individualizing care for portal hypertension[J]. J Hepatol, 2015,63(3):743-752. doi: 10.1016/j.jhep.2015.05.022 pmid: 26047908
[3]	徐小元, 丁惠国, 贾继东, 等. 肝硬化门静脉高压食管胃静脉曲张出血的防治指南[J]. 临床肝胆病杂志, 2016,32(2):203-208.
[4]	Damico G, Pagliaro L, Bosch J. The treatment of portal hypertension: a meta-analytic review[J]. Hepatology, 1995,22(1):332-354. pmid: 7601427
[5]	Bhardwaj A, Kedarisetty C K, Vashishtha C, et al. Carvedilol delays the progression of small oesophageal varices in patients with cirrhosis: a randomised placebo-controlled trial[J]. Gut, 2017,66(10):1838-1843. pmid: 27298379
[6]	Sarin S K, Mishra S R, Sharma P, et al. Early primary prophylaxis with beta-blockers does not prevent the growth of small esophageal varices in cirrhosis: a randomized controlled trial[J]. Hepatol Int, 2013,7(1):248-256. doi: 10.1007/s12072-012-9353-8
[7]	Villanueva C, Colomo A, Bosch A, et al. Transfusion strategies for acute upper gastrointestinal bleeding[J]. N Engl J Med, 2013,368(1):11-21. pmid: 23281973
[8]	Wells M, Chande N, Adams P, et al. Meta-analysis: vasoactive medications for the management of acute variceal bleeds[J]. Aliment Pharmacol Ther, 2012,35(11):1267-1278. pmid: 22486630
[9]	Seo Y S, Park S Y, Kim M Y, et al. Lack of difference among terlipressin, somatostatin, and octreotide in the control of acute gastroesophageal variceal hemorrhage[J]. Hepatology, 2014,60(3):954-963. doi: 10.1002/hep.27006
[10]	Puente A, Hernández-Gea V, Graupera I, et al. Drugs plus ligation to prevent rebleeding in cirrhosis: an updated systematic review[J]. Liver Int, 2014,34(6):823-833. doi: 10.1111/liv.12452
[11]	Mishra S R, Sharma B C, Kumar A, et al. Primary prophylaxis of gastric variceal bleeding comparing cyanoacrylate injection and beta-blockers: a randomized controlled trial[J]. J Hepatol, 2011,54(6):1161-1167. doi: 10.1016/j.jhep.2010.09.031 pmid: 21145834
[12]	El Amin H. A randomized trial of endoscopic variceal ligation versus cyanoacrylate injection for treatment of bleeding junctional varices[J]. Trop Gastroenterol, 2010,31(4):279-284. pmid: 21568143
[13]	Caldwell S. Gastric varices: is there a role for endoscopic cyanoacrylates, or are we entering the BRTO era?[J]. Am J Gastroenterol, 2012,107(12):1784-1790. pmid: 23211846
[14]	Mishra S R, Sharma B C, Kumar A, et al. Endoscopic cyanoacrylate injection versus beta-blocker for secondary prophylaxis of gastric variceal bleed: a randomised controlled trial[J]. Gut, 2010,59(6):729-735. pmid: 20551457
[15]	Hung H H, Chang C J, Hou M C, et al. Efficacy of non-selective beta-blockers as adjunct to endoscopic prophylactic treatment for gastric variceal bleeding: a randomized controlled trial[J]. J Hepatol, 2012,56(5):1025-1032. doi: 10.1016/j.jhep.2011.12.021 pmid: 22266602
[16]	Leithead J A, Rajoriya N, Tehami N, et al. Non-selective beta-blockers are associated with improved survival in patients with ascites listed for liver transplantation[J]. Gut, 2015,64(7):1111-1119. doi: 10.1136/gutjnl-2013-306502 pmid: 25281417

《2016年美国肝病学会肝硬化门静脉高压出血的风险分层、诊断和管理实践指导》解读

Interpretation of Portal Hypertensive Bleeding in Cirrhosis: Risk Stratification, Diagnosis and Management: 2016 Practice Guidance by the American Association for the Study of Liver Diseases

RichHTML

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献 16

相关文章 10

编辑推荐

Metrics

本文评价

[1]	杨凯, 裴宁, 王琦鑫, 蔡兰兰. 一种新型磁性生物贴片的性质[J]. 上海大学学报(自然科学版), 2019, 25(5): 767-775.
[2]	邹玉宝, 惠汝太, 宋雷. 《中国成人肥厚型心肌病诊断与治疗指南》解读[J]. 上海大学学报(自然科学版), 2018, 24(1): 1-8.
[3]	胡树罡, 王磊, 郭兰. 《经皮冠状动脉介入治疗术后运动康复专家共识》解读[J]. 上海大学学报(自然科学版), 2018, 24(1): 9-15.
[4]	王惠, 赵蓉, 周学中. 小鼠心肌层注射方法的改进[J]. 上海大学学报(自然科学版), 2017, 23(6): 835-.
[5]	韩晓博, 郑英虹, 杨力明. 光敏剂在光动力治疗中的研究进展[J]. 上海大学学报(自然科学版), 2017, 23(2): 169-178.
[6]	胡牧仁1, 陈婷2, 杨长青3, 葛步军1. 外泌体在肿瘤精准诊断与治疗中的研究进展[J]. 上海大学学报(自然科学版), 2017, 23(2): 161-168.
[7]	寇佳媛1, 姜月晴1, 田野1,2, 杨力明1. 中药提取物声敏剂在声动力治疗动脉粥样硬化中的应用[J]. 上海大学学报(自然科学版), 2016, 22(3): 318-325.
[8]	王菲, Saumya Das. 基于循环血微小RNA预测心脏再同步化治疗疗效[J]. 上海大学学报(自然科学版), 2016, 22(3): 265-269.
[9]	丁秋蓉, 陈彦好. 心血管疾病的基因治疗[J]. 上海大学学报(自然科学版), 2016, 22(3): 270-279.
[10]	宋安平1,2，张武 1,2，丁广太 1，郑汉垣 1,3. 胆脂瘤诊断的计算模型及算法[J]. 上海大学学报(自然科学版), 2010, 16(1): 26-30.