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.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2014.1
- 수록면
- 308 - 314 (7page)
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초록· 키워드
오류제보하기
Acute variceal bleeding could be a fatal complication in patients with liver cirrhosis. In patients with decompensated liver cirrhosis accompanied by ascites or hepatic encephalopathy, acute variceal bleeding is associated with a high mortality rate. Therefore, timely endoscopic hemostasis and prevention of relapse of bleeding are most important. The treatment goals for acute variceal bleeding are to correct hypovolemia; achieve rapid hemostasis; and prevent early rebleeding, complications related to bleeding, and deterioration of liver function. If variceal bleeding is suspected, treatment with vasopressors and antibiotics should be initiated immediately on arrival to the hospital. Furthermore, to obtain hemodynamic stability, the hemoglobin level should be maintained at >8 g/dL, systolic blood pressure >90 to 100 mm Hg, heart rate <100/min, and the central venous pressure from 1 to 5 mm Hg. When the patient becomes hemodynamically stable, hemostasis should be achieved by performing endoscopy as soon as possible. For esophageal variceal bleeding, endoscopic variceal ligation is usually performed, and for gastric variceal bleeding, endoscopic variceal obturation is performed primarily. If it is considered difficult to achieve hemostasis through endoscopy, salvage therapy may be carried out while keeping the patient hemodynamically stable.
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참고문헌 (23)
참고문헌 신청
Abraldes JG / 2008 / Hepatic venous pressure gradient and prognosis in patients with acute variceal bleeding treated with pharmacologic and endoscopic therapy / J Hepatol 48
Bernard B / 1999 / Antibiotic prophylaxis for the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding: a meta-analysis / Hepatology 29 :
Bosch J / 2008 / Recombinant factor VIIa for variceal bleeding in patients with advanced cirrhosis: a randomized, controlled trial / Hepatology 47 : 1604 ~ 1614
Burroughs AK / 1998 / Optimizing emergency care of upper gastrointestinal bleeding in cirrhotic patients / Scand J Gastroenterol Suppl 226 : 14 ~ 24
Cho SB / 2011 / Variceal bleeding / Korean J Gastrointest Endosc 43 (Suppl 2) : 196 ~ 199
Bernard B / 1999 / Antibiotic prophylaxis for the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding: a meta-analysis / Hepatology 29 :
Bosch J / 2008 / Recombinant factor VIIa for variceal bleeding in patients with advanced cirrhosis: a randomized, controlled trial / Hepatology 47 : 1604 ~ 1614
Burroughs AK / 1998 / Optimizing emergency care of upper gastrointestinal bleeding in cirrhotic patients / Scand J Gastroenterol Suppl 226 : 14 ~ 24
Cho SB / 2011 / Variceal bleeding / Korean J Gastrointest Endosc 43 (Suppl 2) : 196 ~ 199
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