《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.pdfVIP

《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)

摘摘摘要要要: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.

关关关键键键词词词:肝硬化;静脉曲张出血;诊断;治疗

中中中图图图分分分类类类号号号:R575.2文文文献献献标标标志志志码码码:A文文文章章章编编编号号号:1007-2861(2018)03-0336-05

InterpretationofPortalHypertensiveBleedingin

Cirrhosis:RiskStratification,Diagnosisand

Management:2016PracticeGuidanceby

theAmericanAssociationfortheStudy

ofLiverDiseases

SONGWeiping,YANGChangqing

(DepartmentofGastroenterology,TongjiHospitalofTongjiUniversity,Shanghai200065,China)

Abstract:Hemorrhageresultingfromhighpressureofportalveinisacommoncomplica-

tionofdecompensatedlivercirrhosis.Becauseofdifferentcourses,anatomiclocationsof

varicoseveinandcomplications,patientswithcirrhosisneedtobeprudentintheirchoiceof

methodsfordiagnosis,treatmentandpreventionofrebleeding.PortalHypertensiveBleed-

inginCirrhosis:RiskStratification,DiagnosisandManagement:2016PracticeGuidance

bytheAmericanAssociationfortheStudyofLiverDiseases,whichisbasedonagreatdeal

ofclinicaldata,mayserveasaguidelineforclinicalpracticeinChinaaswell.Thispaper,

throughclosereadingofthepracticeguidance,andthroughcomparativeanalysisbetween

theAmericanguidanceandthatinChina,hopestoshedsomenewlightformedicalprac-

titionersonthehandlingofvariousproblemsconnectedwithliverdiseases.

Keywords:cirrhosis;varicosebleeding;diagnosis;treatment

根据有无并发GEV破裂出血、腹水及肝性脑病,肝硬化可分为代偿性肝硬化(compensated

cirrhosis,CC)期和失代偿性肝硬化期.肝硬化进入失代偿期后可出现门脉