2016 肝硬化门静脉高压食管胃静脉曲张出血的防治指南

2016-02-02 中华医学会肝病学分会 临床肝胆病杂志.2016,32(2):203-219.

本指南旨在帮助医生在肝硬化门静脉高压EVB的诊疗和预防工作中做出合理决策,但不是强制性标准,也不可能包括或解决肝硬化门静脉高压EVB诊治中的所有临床问题。因此,临床医生在面对某一患者时,应在充分了解有关本病的最佳临床证据、认真考虑患者具体病情及其意愿的基础上,根据自己的专业知识、临床经验和可利用的医疗资源,制订全面合理的诊疗方案。

中文标题:

2016 肝硬化门静脉高压食管胃静脉曲张出血的防治指南

发布日期:

2016-02-02

简要介绍:

门静脉高压症是指由各种原因导致的门静脉系统压力升 高所引起的一组临床综合征,其最常见病因为各种原因所致的肝硬化。门静脉高压症基本病理生理特征是门静脉系统血流受阻和(或)血流量增加,门静脉及其属支血管内静力压升高并伴侧支循环形成,临床主要表现为腹水、食管胃静脉曲张(gastroesophageal varices,GOV)、食管胃静脉曲张破裂出血(esophago gastricvariceal bleeding,EVB)和肝性脑病等,其中EVB病死率高,是最常见的消化系统急症之一。 

为规范肝硬化门静脉高压 EVB的预防、诊断和治疗,中华医学会肝病学分会、消化病学分会和内镜学分会于2008年组织国内有关专家制订了《肝硬化门静脉高压食管胃静脉曲张出血的防治共 识》。

近7年来,国内外有关肝硬化门静脉高压EVB的临床研究取得一定进展。许多随机对照研究更新了EVB的处理方法,发表了2008年的苏格兰校际指南网络、2012年英国国家卫生与临床研究所指南和 2015年英国指南及BavenoⅥ等。

此外,有关患者教育、基础治疗、如何降低内镜治疗后再出血率,术前术后包括肝功能、门静脉高压及侧枝循环的评估等对治疗方案选择的影响,也是临床存在的突出问题。 

本指南旨在帮助医生在肝硬化门静脉高压EVB的诊疗和预防工作中做出合理决策,但不是强制性标准,也不可能包括或解决肝硬化门静脉高压 EVB诊治中的所有临床问题。

因此,临床医生在面对某一患者时,应在充分了解有关本病的最佳临床证据、认真考虑患者具体病情及其意愿的基础上,根据自己的专业知识、临床 经验和可利用的医疗资源,制订全面合理的诊疗方案。 

制定者:
中华医学会肝病学分会(Chinese Society of Hepatology, CMA)
中华医学会消化病学分会(CSGE,Chinese Society Of Gastroenterology)
中华医学会内镜学分会(CSDE,Chinese Society of Digestive Endoscopy)

拓展指南:肝硬化相关指南:

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    2021-10-19 湘雅科教

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    2021-10-19 湘雅科教

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    2021-10-19 湘雅科教

    不错

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