在肝硬化患者中预防EVRB的证据:系统性审查
Ye Liu1, Xiaoyan Wang1, Yingjia Gu1
1Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
概括
在肝硬化患者中预防食管胃水复出血 (EVRB) 需要更新的策略. 黄金标准涉及非选择性β-阻断剂 (NSBB) 和内透视绑定 (EVL), TIPS和手术作为替代方案.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 内部医学 内部医学
背景情况:
- 食管胃水复出血 (EVRB) 由于目前的预防和治疗策略不足,造成了重大临床挑战.
- 肝硬化患者患有EVRB的风险很高,因此需要对管理方法进行全面审查.
研究的目的:
- 在肝硬化患者中系统地审查和更新预防和治疗食管胃水复出血 (EVRB) 的当代策略.
- 根据当前的证据,确定有效的风险管理,预防措施和治疗选择.
主要方法:
- 进行了当代研究的系统审查,搜索主要的指南网站,数据库和专业协会.
- 提取了关键发现,重点是对EVRB的评估,风险分层,预防和治疗方式.
主要成果:
- 肝静脉压梯度 (HVPG) >18 mmHg预测了EVRB. 管理包括解决原发性肝病,使用非选择性β-阻断剂 (NSBBs) 与内透视结合 (EVL) 作为二次预防的标准.
- 对于耐火病例,建议进行横内肝移植系统 (TIPS),而对于不适合内镜治疗或TIPS的患者,则考虑进行外科手术.
- 传统中医药配方显示出改善肝纤维化和静脉的潜力.
结论:
- 目前EVRB预防和治疗的策略正在发展,现有既定和替代疗法可供选择.
- 有效的管理需要采用多方面的方法,包括风险评估,初级疾病控制和根据患者状态和治疗反应量身定制的干预措施.
- 对新型治疗剂和综合管理协议的进一步研究是有必要的.
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