Current Concepts: Management of Varices and Variceal Hemorrhage in Cirrhosis.

被引：655

作者：

Garcia-Tsao, Guadalupe ^{[1
]}

Bosch, Jaime ^{[2
]}

机构：

[1] Yale Univ, Sch Med, Sect Digest Dis, New Haven, CT 06520 USA

[2] Univ Barcelona, Hosp Clin, Hepat Hemodynam Lab, Liver Unit, Barcelona, Spain

来源：

NEW ENGLAND JOURNAL OF MEDICINE | 2010年 / 362卷 / 09期

关键词：

PORTAL HYPERTENSIVE GASTROPATHY; RANDOMIZED CONTROLLED-TRIAL; VENOUS-PRESSURE GRADIENT; INTRAHEPATIC PORTOSYSTEMIC SHUNT; SMALL ESOPHAGEAL-VARICES; NATURAL-HISTORY; PHARMACOLOGICAL-TREATMENT; CYANOACRYLATE INJECTION; ENDOSCOPIC TREATMENT; BAND LIGATION;

D O I：

10.1056/NEJMra0901512

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Gastroesophageal varices are present at diagnosis in almost half of patients with cirrhosis, and variceal hemorrhage continues to be a lethal complication of cirrhosis. This review explains the three main challenges in clinical management: primary prophylaxis to prevent a first episode of hemorrhage, the treatment of acute bleeding episodes, and secondary prophylaxis to prevent recurrence of variceal hemorrhage. Copyright © 2010 Massachusetts Medical Society.

引用

页码：823 / 832

页数：10

共 66 条

[1] Hemodynamic response to pharmacological treatment of portal hypertension and long-term prognosis of cirrhosis [J].

Abraldes, JG ;

Tarantino, I ;

Turnes, J ;

Garcia-Pagan, JC ;

Rodés, J ;

Bosch, J .

HEPATOLOGY, 2003, 37 (04) :902-908

[2] Hepatic venous pressure gradient and prognosis in patients with acute variceal bleeding treated with pharmacologic and endoscopic therapy [J].

Abraldes, Juan G. ;

Villanueva, Candid ;

Banares, Rafael ;

Aracil, Carles ;

Catalina, Maria Vega ;

Garcia-Pagan, Juan Carlos ;

Bosch, Jaime .

JOURNAL OF HEPATOLOGY, 2008, 48 (02) :229-236

[3] Simvastatin treatment improves liver sinusoidal endothelial dysfunction in CCl4 cirrhotic rats [J].

Abraldes, Juan G. ;

Rodriguez-Vilarrupla, Aina ;

Graupera, Mariona ;

Zafra, Carmen ;

Garcia-Caldero, Hector ;

Garcia-Pagan, Juan Carlos ;

Bosch, Jaime .

JOURNAL OF HEPATOLOGY, 2007, 46 (06) :1040-1046

[4] Simvastatin Lowers Portal Pressure in Patients With Cirrhosis and Portal Hypertension: A Randomized Controlled Trial [J].

Abraldes, Juan G. ;

Albillos, Agustin ;

Banares, Rafael ;

Turnes, Juan ;

Gonzalez, Rosario ;

Garcia-Pagan, Juan Carlos ;

Bosch, Jaime .

GASTROENTEROLOGY, 2009, 136 (05) :1651-1658

[5] Predictors of early re-bleeding and mortality after acute variceal haemorrhage in patients with cirrhosis [J].

Bambha, K. ;

Kim, W. R. ;

Pedersen, R. ;

Bida, J. P. ;

Kremers, W. K. ;

Kamath, P. S. .

GUT, 2008, 57 (06) :814-820

[6] Randomized comparison of long-term carvedilol and propranolol administration in the treatment of portal hypertension in cirrhosis [J].

Bañares, R ;

Moitinho, E ;

Matilla, A ;

García-Pagán, JC ;

Lampreave, JL ;

Piera, C ;

Abraldes, JG ;

De Diego, A ;

Albillos, A ;

Bosch, J .

HEPATOLOGY, 2002, 36 (06) :1367-1373

[7] Endoscopic treatment versus endoscopic plus pharmacologic treatment for acute variceal bleeding:: A meta-analysis [J].

Bañares, R ;

Albillos, A ;

Rincón, D ;

Alonso, S ;

González, M ;

Ruiz-del-Arbol, L ;

Salcedo, M ;

Molinero, LM .

HEPATOLOGY, 2002, 35 (03) :609-615

[8] Antibiotic prophylaxis for the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding:: A meta-analysis [J].

Bernard, B ;

Grangé, JD ;

Khac, EN ;

Amiot, X ;

Opolon, P ;

Poynard, T .

HEPATOLOGY, 1999, 29 (06) :1655-1661

[9] Non-invasive prediction of clinically significant portal hypertension and esophageal varices in patients with compensated liver cirrhosis (vol 103, pg 1159, 2008) [J].

Berzigotti ;

Gilabert ;

Abraldes ;

Nicolau ;

Bru ;

Bosch ;

Garcia-Pagan .

AMERICAN JOURNAL OF GASTROENTEROLOGY, 2008, 103 (08) :2167-2167

[10] Noninvasive prediction of clinically significant portal hypertension and esophageal varices in patients with compensated liver cirrhosis [J].

Berzigotti, Annalisa ;

Gilabert, Rosa ;

Abraldes, Juan G. ;

Nicolau, Carlos ;

Bru, Concepcion ;

Bosch, Jaime ;

Garcia-Pagan, Juan C. .

AMERICAN JOURNAL OF GASTROENTEROLOGY, 2008, 103 (05) :1159-1167

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