门高血压的出血并发症 门高血压的出血并发症
Chitranshu Vashishtha1, Shiv Kumar Sarin1
1Department of Hepatology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi 110070, India.
Clinics in liver disease
|June 30, 2024
概括
在门高血压中,急性水出血是危急的紧急情况. 治疗包括血液动力复苏,药物,如非选择性β-阻断剂,内镜带绑定,和潜在的跨内肝港系统分流 (TIPS) 耐火病例.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 干预性内镜检查是干预性的内镜检查.
背景情况:
- 急性水出血是门高血压的主要并发症,占肝硬化患者上部胃肠道出血的三分之二.
- 它代表了危及生命的紧急情况,需要迅速有效的管理策略.
研究的目的:
- 概述目前针对急性水出血的管理指南.
- 讨论医疗疗,内镜干预和干预放射学在治疗这种疾病中的作用.
主要方法:
- 最初的评估包括评估出血的严重程度,血液动力复苏,预防性抗生素和静脉注射的支柱状血管收缩剂.
- 内镜带绑定是主要的内镜治疗方法.
- 横性肝内端口系统分流 (TIPS) 仅用于耐火性出血或作为高风险患者的预防措施.
主要成果:
- 非选择性β抑制剂对于通过降低肝血管压力梯度来预防水出血和再出血至关重要.
- 内镜带绑定对于食道变节是有效的.
- 烯酸盐注射是胃变节的首选治疗方法 (IGV1和GOV2分类).
结论:
- 结合药理学,内镜和干预策略的多模式方法对于治疗急性水出血至关重要.
- 及时干预适当的疗法,包括TIPS,可以改善复杂病例的结果.
- 内镜超声波有助于胃的管理.
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