Value of endoscopic ultrasonography in the management of haemorrhagic complications of portal hypertension
Value of endoscopic ultrasonography in the management of haemorrhagic complications of portal hypertension
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DOI：
10.1007/bf02961812
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发表时间：
2007-01-01
期刊：
影响因子：
--
通讯作者：
Castellani, P.
中科院分区：
文献类型：
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作者：
Boustiere, Ch.;Castellani, P.
输卵管破裂出血是一种常见的并发症，占急性期死亡率的30%。它与门静脉压力升高、静脉曲张的大小和肝功能不全有关。在缺乏准确和易于重现的血流动力学标准的情况下，内窥镜超声检查允许对门静脉系统和侧支静脉进行全面的解剖和血流动力学研究。这些新因素将有助于选择静脉曲张出血的高危患者，并采用预防出血的最佳策略。EUS将能够找到对常规治疗反应差的预测因素，并评估创建提示的可能性。通过超声引导或超声辅助穿刺术治疗深静脉曲张，主要是穿透大静脉，在技术上是可行的，但仍需进行评估。
Haemorrhage by rupture of OV is a frequent complication responsible for 30% of mortality in the acute phase. It is linked to the increase of portal pressure, the size of the varices and the hepatic insufficiency. In the absence of accurate and easily reproducible hemodynamic criteria, endoscopic ultrasonography allows for a global anatomic and hemodynamic study of the portal system and of the collateral veins. These new elements will help to select patients with high risk of variceal bleeding and to adapt the best strategy for preventing haemorrhage. EUS will be able to find the predictive factors of bad response to the usual treatments and to assess the possibilities to create a TIPS. The treatment by ultrasonographically guided or ultrasonographically assisted puncture of deep varices and mainly of penetrating large veins is technically possible but still needs to be assessed.