Treatment of portal hypertension

查看全文 作　　者：Khurram [1]Bari;Guadalupe Garcia-[1]Tsao

机构地区：[1]Section of Digestive Diseases,Yale University School of Medicine,New Haven,CT and VA-Connecticut Healthcare System,West Haven,CT 06520,United States

出　　处：《World Journal of Gastroenterology》索引2012年第18卷第11期,共10页

摘　　要：Portal hypertension is the main complication of cirrhosis and is defined as an hepatic venous pressure gradient(HVPG) of more than 5 mmHg.Clinically significant portal hypertension is defined as HVPG of 10 mmHg or more.Development of gastroesophageal varices and variceal hemorrhage are the most direct consequence of portal hypertension.Over the last decades significant advancements in the field have led to standard treatment options.These clinical recommendations have evolved mostly as a result of randomized controlled trials and consensus conferences among experts where existing evidence has been reviewed and future goals for research and practice guidelines have been proposed.Management of varices/variceal hemorrhage is based on the clinical stage of portal hypertension.No specific treatment has shown to prevent the formation of varices.Prevention of first variceal hemorrhage depends on the size/characteristics of varices.In patients with small varices and high risk of bleeding,nonselective b-blockers are recommended,while patients with medium/large varices can be treated with either b-blockers or esophageal band ligation.Standard of care for acute variceal hemorrhage consists of vasoactive drugs,endoscopic band ligation and antibiotics prophylaxis.Transjugular intrahepatic portosystemic shunt(TIPS) is reserved for those who fail standard of care or for patients who are likely to fail('early TIPS').Prevention of recurrent variceal hemorrhage consists of the combination of b-blockers and endoscopic band ligation. 关键词：治疗方案高压受体阻滞剂静脉曲张临床意义毫米汞柱 TIPS 压力梯度

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Treatment of portal hypertension

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