지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
초록· 키워드
오류제보하기
Gastroesophageal varices are the most common lethal complication of cirrhosis that result most directly from portal hypertension. Patients with cirrhosis and gastroesophageal varices have an hepatic venous pressure gradient (HVPG) of at least 10～12 mmHg. An increased portal pressure gradient results from both an increase in resistance to portal flow and an increase in portal blood inflow. Patients whose HVPG decreased to < 12 mmHg or at least 20% from baseline levels have a lower probability of developing recurrent variceal hemorrhage. Therefore, a reduction in HVPG is most important. Nonselective β-blockers are the gold standard in the prevention of first variceal hemorrhage in pateints with medium/large varices. Endoscopic variceal ligation (EVL) has been established as an alternative to nonselective β-blockers for the prevention of initial variceal hemorrhage. The combination of vasoconstrictive pharmacological therapy and variceal ligation is the preferred approach to the management of acute variceal hemorrhage. Prophylactic antibiotic therapy is considered standard of care as adjunctive treatment of the acute bleeding episode. Both combination pharmacological therapy and EVL have been proven effective for the prevention of recurrent variceal hemorrhage. For failures of medical therapy, TIPS or surgically created shunts are excellent salvage procedures. (Korean J Med 75:6-14, 2008)
목차
등록된 정보가 없습니다.
참고문헌 (23)
참고문헌 신청
/ 2007 / Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis / Hepatology 46 : 922 ~ 938
Abraldes JG / 2003 / Hemodynamic response to pharmacological treatment of portal hypertension and long-term prognosis of cirrhosis / Hepatology 37 : 902 ~ 908
Bhathal PS / 1985 / Reduction of the increased portal vascular resistance of the isolated perfused cirrhotic rat liver by vasodilators / J Hepatol 1 : 325 ~ 337+
Bosch J / 2003 / Prevention of variceal rebleeding / Lancet 361 : 952 ~ 954
Carbonell N / 2004 / Improved survival after variceal bleeding in patients with cirrhosis over the past two decades / Hepatology 40 : 652 ~ 659
Abraldes JG / 2003 / Hemodynamic response to pharmacological treatment of portal hypertension and long-term prognosis of cirrhosis / Hepatology 37 : 902 ~ 908
Bhathal PS / 1985 / Reduction of the increased portal vascular resistance of the isolated perfused cirrhotic rat liver by vasodilators / J Hepatol 1 : 325 ~ 337+
Bosch J / 2003 / Prevention of variceal rebleeding / Lancet 361 : 952 ~ 954
Carbonell N / 2004 / Improved survival after variceal bleeding in patients with cirrhosis over the past two decades / Hepatology 40 : 652 ~ 659
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