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肝硬化门静脉高压食管胃静脉曲张出血的防治指南

中华医学会肝病学分会 中华医学会消化病学分会 中华医学会内镜学分会

中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会内镜学分会. 肝硬化门静脉高压食管胃静脉曲张出血的防治指南[J]. 临床肝胆病杂志, 2016, 32(2): 203-219. DOI: 10.3969/j.issn.1001-5256.2016.02.002
引用本文: 中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会内镜学分会. 肝硬化门静脉高压食管胃静脉曲张出血的防治指南[J]. 临床肝胆病杂志, 2016, 32(2): 203-219. DOI: 10.3969/j.issn.1001-5256.2016.02.002
Chinese Society of Hepatology, Chinese Medical Association, Chinese Society of Gastroenterology, Chinese Medical Association, Chinese Society of Endoscopy,Chinese Medical Association. Guidelines for the diagnosis and treatment of esophageal and gastric variceal bleeding in cirrhotic portal hypertension[J]. J Clin Hepatol, 2016, 32(2): 203-219. DOI: 10.3969/j.issn.1001-5256.2016.02.002
Citation: Chinese Society of Hepatology, Chinese Medical Association, Chinese Society of Gastroenterology, Chinese Medical Association, Chinese Society of Endoscopy,Chinese Medical Association. Guidelines for the diagnosis and treatment of esophageal and gastric variceal bleeding in cirrhotic portal hypertension[J]. J Clin Hepatol, 2016, 32(2): 203-219. DOI: 10.3969/j.issn.1001-5256.2016.02.002

肝硬化门静脉高压食管胃静脉曲张出血的防治指南

DOI: 10.3969/j.issn.1001-5256.2016.02.002
详细信息
  • 中图分类号: R575.2

Guidelines for the diagnosis and treatment of esophageal and gastric variceal bleeding in cirrhotic portal hypertension

  • 摘要:

    <正>1概述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(esophagogastric variceal bleeding,EVB)和肝性脑病等,其中

     

  • [1] Chinese Society of Hepatology,Chinese Medical Association;Chinese Society of Gastroenterology,Chinese Medical Association;Chinese Society of Endoscopy,Chinese Medical Association.Consensus on prevention and treatment of esophagogastric variceal bleeding in patients with cirrhotic portal hypertension(2008,Hangzhou)[J].Chin J Hepatol,2008,16(8):564-570.中华医学会消化病学分会,中华医学会肝病学分会,中华医学会内镜学分会.肝硬化门静脉高压食管胃静脉曲张出血的防治共识(2008,杭州)[J].中华肝脏病杂志,2008,16(8):564-570.
    [2]de FRANCHIS R,Baveno VI Faculty.Expanding consensus in portal hypertension:report of the Baveno VI Consensus Workshop:stratifying risk and individualizing care for portal hypertension[J].J Hepatol,2015,63(3):743-752.
    [3]HWANG JH,SHERGILL AK,ACOSTA RD,et al.The role of endoscopy in the management of variceal hemorrhage[J].Gastrointest Endosc,2014,80(2):221-227.
    [4]GUTURU P,SAGI SV,AHN D,et al.Capsule endoscopy with PILLCAM ESO for detecting esophageal varices:a meta-analysis[J].Minerva Gastroenterol Dietol,2011,57(1):1-11.
    [5]COLLI A,GANA JC,TURNER D,et al,Capsule endoscopy for the diagnosis of oesophageal varices in people with chronic liver disease or portal vein thrombosis[J].Cochrane Database Syst Rev,2014,10:cd008760.
    [6]HAMMOUD GM,IBDAH JA.Utility of endoscopic ultrasound in patients with portal hypertension[J].World J Gastroenterol,2014,20(39):14230-14236.
    [7]CHEN TW,YANG ZG,LI X,et al.Evaluation of entire gastric fundic and esophageal varices secondary to posthepatitic cirrhosis:portal venography using64-row MDCT[J].Abdom Imaging,2010,35(1):1-7.
    [8]SHEN M,ZHU KS,MENG XC,et al.Evaluation of esophageal varices and predicting the risk of esophageal varices bleeding with multidetector CT in patients with portal hypertension[J].Natl Med J China,2010,90(41):2911-2915.(in Chinese)沈敏,朱康顺,孟晓春,等.门静脉高压症食管静脉曲张的CT诊断及出血风险预测[J].中华医学杂志,2010,90(41):2911-2915.
    [9]LIU GQ,HUA J,SHEN JL.Clinical value of CT portography to predicting esophagogastric variceal bleeding in liver cirrhosis patients complicated with portal hypertension[J].J Chin Pract Diagn Ther,2015,29(4):396-398.(in Chinese)刘桂勤,华静,沈加林.CT门静脉血管成像预测肝硬化门静脉高压食管胃底静脉曲张破裂出血价值[J].中华实用诊断与治疗杂志,2015,29(4):396-398.
    [10]SHI B,ZHU H,ZHENG JG,et al.Evaluation of CT partal angiography in isolated gastric varices before and after endoscipic therapy[J].Chin Hepatol,2013,18(10):659-663.(in Chinese)史琲,朱晖,郑嘉岗,等.门静脉CTA对孤立性胃静脉曲张内镜下治疗前后的评估[J].肝脏,2013,18(10):659-663.
    [11]WU MP,XIE Y,SONG B,et al.Grades for esophageal varices in patients with portal hypertension-multidetector CT comparison with endoscopy[J/CD].Chin J Digest Med Imageol:Electronic Edition,2014,4(3):108-111.(in Chinese)吴明蓬,谢艳,宋彬,等.门静脉高压症患者食管静脉曲张多层螺旋CT与内镜分级的相关性[J/CD].中华消化病与影像杂志:电子版,2014,4(3):108-111.
    [12]LI N,AO GK,WANG X,et al.Clinical application of magnetic resonance angiography in morphological evaluation of esophageal and gastric varices[J].Chin Gen Pract,2009,12(8):681-683.(in Chinese)李楠,敖国昆,王欣,等.磁共振血管成像在食管胃底静脉曲张形态学评估中的临床应用[J].中国全科医学,2009,12(8):681-683.
    [13]SHIN SU,LEE JM,YU MH,et al,Prediction of esophageal varices in patients with cirrhosis:usefulness of three-dimensional MR elastography with echo-planar imaging technique[J].Radiology,2014,272(1):143-153.
    [14]HU Z,LI Y,LI C,et al.Using ultrasonic transient elastometry(fibroscan)to predict esophageal varices in patients with viral liver cirrhosis[J].Ultrasound Med Biol,2015,41(6):1530-1537.
    [15]ABD EI RIHIM AY,OMAR RF,FATHALAH W,et al.Role of fibroscan and APRI in detection of liver fibrosis:a systematic review and meta-analysis[J].Arab J Gastroenterol,2013,14(2):44-50.
    [16]LINGHU EQ,FENG J.Development of a classification system for gastroesophageal varices according to its location,diameter and risk of bleeding[J].Chin J Dig Endosc,2008,10(25):507-511.(in Chinese)令狐恩强,冯佳.位置、直径、出血风险在食管胃底静脉曲张破裂出血患者分型中应用初探[J].中华消化内镜杂志,2008,10(25):507-511.
    [17]Committee of esophageal varicosity,Society of Digestive Endoscopy of Chinese Medical Association.Tentative guidelines for endoscopic diagnosis and treatment of varicosity and variceal bleeding in digestive tract(2009)[J].Chin J Dig Endosc,2010,27(1):1-7.(in Chinese)中华医学会消化内镜学分会食管胃静脉曲张学组.消化道静脉曲张及出血的内镜诊断和治疗规范试行方案(2009年)[J].中华消化内镜杂志,2010,27(1):1-7.
    [18]LI MR,XU XY.Researches on the prevention and treatment of bleeding gastroesophageal varices secondary to portal hypertensionin patients with cirrhosis[J].Chin J Hepatol,2015,23(4):247-249.(in Chinese)李敏然,徐小元.肝硬化门静脉高压食管胃静脉曲张出血的防治研究[J].中华肝脏病杂志,2015,23(4):247-249.
    [19]CREMERS I,RIBEIRO S.Management of variceal and nonvariceal upper gastrointestinal bleeding in patients with cirrhosis[J].Therap Adv Gastroenterol,2014,7(5):206-216.
    [20]D'AMICO G,PASTA L,MORABITO A,et al.Competing risks and prognostic stages of cirrhosis:a 25-year inception cohort study of 494patients[J].Aliment Pharmacol Ther,2014,39(10):1180-1193.
    [21]QI X,DAI J,YANG M,et al.Association between portal vein thrombosis and survival in non-liver-transplant patients with liver cirrhosis:a systematic review of the literature[J].Gastroenterol Res Pract,2015,2015:480842.
    [22]ASRANI SK,KAMATH PS.Prediction of early mortality after variceal bleeding:score one more for MELD[J].Gastroenterology,2014,146(2):337-339.
    [23]GROSZMANN RJ,GARCIA-TSAO G,BOSCH J,et al.Betablockers to prevent gastroesophageal varices in patients with cirrhosis[J].N Engl J Med,2005,353(21):2254-2261.
    [24]TRIPATHI D,STANLEY AJ,HAYES PC,et al.UK guidelines on the management of variceal haemorrhage in cirrhotic patients[J].Gut,2005,64(11):1680-1704.
    [25]QI XS,BAO YX,BAI M,et al.Nonselective beta-blockers in cirrhotic patients with no or small varices:a meta-analysis[J].World J Gastroenterol,2015,21(10):3100-3108.
    [26]PAGLIARO L,D'AMICO G,SRENSEN TI,et al.Prevention of first bleeding in cirrhosis.A meta-analysis of randomized trials of nonsurgical treatment[J].Ann Intern Med,1992,117(1):59-70.
    [27]D'AMICO G,PAGLIARO L,BOSCH J.Pharmacological treatment of portal hypertension:an evidence-based approach[J].Semin Liver Dis,1999,19(4):475-505.
    [28]GLUUD LL,KRAG A.Banding ligation versus beta-blockers for primary prevention in oesophageal varices in adults[J].Cochrane Database Syst Rev,2012,8:cd004544.
    [29]HERNNDEZ-GEA V,ARACIL C,COLOMO A,et al.Development of ascites in compensated cirrhosis with severe portal hypertension treated withβ-blockers[J].Am J Gastroenterol,2012,107(3):418-427.
    [30]SENZOLO M,CHOLONGITAS E,BURRA P,et al.Beta-Blockers protect against spontaneous bacterial peritonitis in cirrhotic patients:a meta-analysis[J].Liver Int,2009,29(8):1189-1193.
    [31]BOSCH J.Carvedilol for portal hypertension in patients with cirrhosis[J].Hepatology,2010,51(6):2214-2218.
    [32]TRIPATHI D,FERGUSON JW,KOCHAR N,et al.Randomized controlled trial of carvedilol versus variceal band ligation for the prevention of the first variceal bleed[J].Hepatology,2009,50(3):825-833.
    [33]REIBERGER T,ULBRICH G,FERLITSCH A,et al.Carvedilol for primary prophylaxis of variceal bleeding in cirrhotic patients with haemodynamic non-response to propranolol[J].Gut,2013,62(11):1634-1641.
    [34]HOBOLTH L,MLLER S,GRNBK H,et al.Carvedilol or propranolol in portal hypertension?A randomized comparison[J].Scand J Gastroenterol,2012,47(4):467-474.
    [35]ABRALDES JG,ALBILLOS A,BAARES R,et al.Simvastatin lowers portal pressure in patients with cirrhosis and portal hypertension:a randomized controlled trial[J].Gastroenterology,2009,136(5):1651-1658.
    [36]GLUUD LL,LANGHOLZ E,KRAG A.Meta-analysis:isosorbidemononitrate alone or with either beta-blockers or endoscopic therapy for the management of oesophageal varices[J].Aliment Pharmacol Ther,2010,32(7):859-871.
    [37]HERATH CB,GRACE JA,ANGUS PW.Therapeutic potential of targeting the renin angiotensin system in portal hypertension[J].World J Gastrointest Pathophysiol,2013,4(1):1-11.
    [38]SCHEPKE M,WIEST R,FLACKE S,et al.Irbesartan plus lowdose propranolol versus low-dose propranolol alone in cirrhosis:a placebo-controlled,double-blind study[J].Am J Gastroenterol,2008,103(5):1152-1158.
    [39]KIM DH,PARK JY.Prevention and management of variceal hemorrhage[J].Int J Hepatol,2013,2013:434609.
    [40]ABECASIS R,KRAVETZ D,FASSIO E,et al.Nadolol plus spironolactone in the prophylaxis of first variceal bleed in nonascitic cirrhotic patients:a preliminary study[J].Hepatology,2003,37(2):359-365.
    [41]PIAI G,CIPOLLETTA L,CLAAR M,et al.Prophylactic sclerotherapy of high-risk esophageal varices:results of a multicentric prospective controlled trial[J].Hepatology,1988,8(6):1495-1500.
    [42]D'AMICO G,PAGLIARO L,BOSCH J.The treatment of portal hypertension:a meta-analytic review[J].Hepatology,1995,22(1):332-354.
    [43]The Veterans Affairs Cooperative Variceal Sclerotherapy Group.Prophylactic sclerotherapy for esophageal varices in men with alcoholic liver disease:a randomized,single-blind,multicenter clinical trial[J].N Engl J Med,1991,324(25):1779-1784.
    [44]BAI M,QI X,YANG M,et al.Combined therapies versus monotherapies for the first variceal bleeding in patients with high-risk varices:a meta-analysis of randomized controlled trials[J].J Gastroenterol Hepatol,2014,29(3):442-452.
    [45]MISHRA SR,SHARMA BC,KUMAR A,et al.Primary prophylaxis of gastric variceal bleeding comparing cyanoacrylate injection and betablockers:a randomized controlled trial[J].J Hepatol,2011,54(6):1161-1167.
    [46]GARCIA-TSAO G,BOSCH J.Management of varices and variceal hemorrhage in cirrhosis[J].N Engl J Med,2010,362(9):823-832.
    [47]D'AMICO G,PIETROSI G,TARANTINO I,et al.Emergency sclerotherapy versus vasoactive drugs for variceal bleeding in cirrhosis:a cochrane meta-analysis[J].Gastroenterology,2003,124(5):1277-1291.
    [48]GROSZMANN RJ,KRAVETZ D,BOSCH J,et al.Nitroglycerin improves the hemodynamic response to vasopressin in portal hypertension[J].Hepatology,1982,2(6):757-762.
    [49]LIU F,LU W,YUAN YZ,et al.Efficacy of vasopressin in treatment of esophagogastric variceal bleeding induced by liver cirrhosis[J].Shanghai Med J,1997,20(10):599-600.(in Chinese)刘菲,陆玮,袁耀宗,等.血管加压素治疗肝硬化食管静脉曲张出血[J].上海医学,1997,20(10):599-600.
    [50]JIN R,LU Y,YU ZL,et al.Clinical study on somatostatin and vasopessin in tratment of esophageal varices bleeding[J].J Clin Hepatol,1999,15(3):163-168.(in Chinese)金瑞,陆英,于中麟,等.生长抑素与血管加压素治疗食管静脉曲张出血多中心对照研究[J].临床肝胆病杂志,1999,15(3):163-168.
    [51]Cooperative Study Group of Octreotide in China.Efficacy of octreotide in the treatment of acute variceal bleeding in cirrhotic patients:a prospective,multicentric and randomized clinical trial[J].Chin J Dig,2005,25(1):37-40.(in Chinese)奥曲肽全国协作组.两种剂量奥曲肽治疗食管、胃静脉曲张大出血多中心随机对照临床疗效观察[J].中华消化杂志,2005,25(1):37-40.
    [52]SEO YS,PARK SY,KIM MY,et al.Lack of difference among terlipressin,somatostatin,and octreotide in the control of acute gastroesophageal variceal hemorrhage[J].Hepatology,2014,60(3):954-963.
    [53]WELLS M,CHANDE N,ADAMS P,et al.Meta-analysis:vasoactive medications for the management of acute variceal bleeds[J].Aliment Pharmacol Ther,2012,35(11):1267-1278.
    [54]WANG C,HAN J,XIAO L,et al.Efficacy of vasopressin/terlipressin and somatostatin/octreotide for the prevention of early variceal rebleeding after the initial control of bleeding:a systematic review and meta-analysis[J].Hepatol Int,2015,9(1):120-129.
    [55]LEE YY,TEE HP,MAHADEVA S.Role of prophylactic antibiotics in cirrhotic patients with variceal bleeding[J].World J Gastroenterol,2014,20(7):1790-1796.
    [56]SREEDHARAN A,MARTIN J,LEONTIADIS GI,et al.Proton pump inhibitor treatment initiated prior to endoscopic diagnosis in upper gastrointestinal bleeding[J].Cochrane Database Syst Rev,2010,(7):cd005415.
    [57]SHAHEEN NJ,STUART E,SCHMITZ SM,et al.Pantoprazole reduces the size of post banding ulcers after variceal band ligation:a randomized,controlled trial[J].Hepatology,2005,41(3):588-594.
    [58]JANG WS,SHIN HP,LEE JI,et al.Proton pump inhibitor administration delays rebleeding after endoscopic gastric variceal obturation[J].World J Gastroenterol,2014,20(45):17127-17131.
    [59]MIN YW,LIM KS,MIN BH,et al.Proton pump inhibitor use significantly increasesthe risk of spontaneous bacterial peritonitis in1965 patients with cirrhosis andascites:a propensity score matched cohort study[J].Aliment Pharmacol Ther,2014,40(6):695-704.
    [60]DULTZ G,PIIPER A,ZEUZEM S,et al.Proton pump inhibitor treatment is associatedwith the severity of liver disease and increased mortality in patients with cirrhosis[J].Aliment Pharmacol Ther,2015,41(5):459-466.
    [61]TERG R,CASCIATO P,GARBE C,et al.Proton pump inhibitor therapy does not increase the incidence of spontaneous bacterial peritonitis in cirrhosis:a multicenter prospective study[J].J Hepatol,2015,62(5):1056-1060.
    [62]CHO SB,PARK KJ,LEE JS,et al.Comparison of terlipressin and octreotide with variceal ligation for controlling acute esophageal variceal bleeding——a randomized prospective study[J].Korean J Hepatol,2006,12(3):385-393.
    [63]ABID S,JAFRI W,HAMID S,et al.Terlipressin vs octreotide in bleeding esophageal varices as an adjuvant therapy with endoscopic band ligation:a randomized double-blind placebo-controlled trial[J].Am J Gastroenterol,2009,104(3):617-623.
    [64]JIN QY,WU P,XU ZY,et al.Efficacy of endoscopic band ligation combined with drugs in the treatment of esophageal variceal bleeding[J].West China Med J,2012,27(8):1129-1132.(in Chinese)晋琼玉,吴攀,徐泽燕,等.内镜下套扎术联合药物治疗食管静脉曲张出血的疗效观察[J].华西医学,2012,27(8):1129-1132.
    [65]HE XL.Efficacy of octreotide alone versus combined with sclerosing agent in treatment of esophageal variceal bleeding[J].Chin J Dig Endosc,2002,19(3):171-172.(in Chinese)何晓玲.单用奥曲肽与联用硬化剂治疗食管静脉曲张破裂出血的疗效对比[J].中华消化内镜杂志,2002,19(3):171-172.
    [66]HOLSTER IL,KUIPERS EJ,van BUUREN HR,et al.Self-expandable metal stents as definitive treatment for esophageal variceal bleeding[J].Endoscopy,2013,45(6):485-488.
    [67]ZAKARIA MS,HAMZA IM,MOHEY MA,et al.The first Egyptian experience using new self-expandable metal stents in acute esophageal variceal bleeding:pilot study[J].Saudi J Gastroenterol,2013,19(4):177-181.
    [68]ZHANG D,SHI R,YAO J,et al.Treatment of massive esophageal variceal bleeding by sengstaken-blackmore tube compression and intensive endoscopic detachable mini-loop ligation:a retrospective study in 83 patients[J].Hepatogastroenterology,2015,62(137):77-81.
    [69]RSSLE M.TIPS:25 years later[J].J Hepatol,2013,59(5):1081-1093.
    [70]SUHOCKI PV,LUNGREN MP,KAPOOR B,et al.Transjugular intrahepatic portosystemic shunt complications:prevention and management[J].Semin Intervent Radiol,2015,32(2):123-132.
    [71]SIRAMOLPIWAT S.Transjugular intrahepatic portosystemic shunts and portal hypertension-related complications[J].World J Gastroenterol,2014,20(45):16996-17010.
    [72]GARCA-PAGN JC,CACA K,BUREAU C,et al.Early use of TIPS in patients with cirrhosis and variceal bleeding[J].N Engl J Med,2010,362(25):2370-2379.
    [73]HUANG L,YU QS,ZHANG Q,et al.Transjugular intrahepatic portosystemic shunt versus surgical shunting in the management of portal hypertension[J].Chin Med J(Engl),2015,128(6):826-834.
    [74]ORLOFF MJ.Fifty-three years'experience with randomized clinical trials of emergency portacaval shunt for bleeding esophageal varices in cirrhosis:1958-2011[J].JAMA Surg,2014,149(2):155-169.
    [75]SATAPATHY SK,SANYAL AJ.Nonendoscopic management strategies for acute esophagogastric variceal bleeding[J].Gastroenterol Clin North Am,2014,43(4):819-833.
    [76]WU ZY.Choice of surgical strategy in the treatment of cirrhotic portal hypertension[J].J Surg Concepts Pract,2009,14(1):1-3.(in Chinese)吴志勇.肝硬化门静脉高压症外科治疗的合理选择[J].外科理论与实践,2009,14(1):1-3.
    [77]SHI KQ,LIU WY,PAN ZZ,et al.Secondary prophylaxis of variceal bleeding for cirrhotic patients:a multiple-treatments meta-analysis[J].Eur J Clin Invest,2013,43(8):844-854..
    [78]GARBUZENKO DV.Contemporary concepts of the medical therapy of portal hypertension under liver cirrhosis[J].World J Gastroenterol,2015,21(20):6117-6126.
    [79]ALBILLOS A,TEJEDOR M.Secondary prophylaxis for esophageal variceal bleeding[J].Clin Liver Dis,2014,18(2):359-370.
    [80]LI B,HUANG ZG,SHEN JW,et al.Efficacy of carvedilol versus propranolol in reducing cirrhotic portal hypertension:a controlled study[J].Zhejiang Med J,2012,34(24):1973-1975.(in Chinese)李波,黄志刚,沈健伟,等.卡维地洛与普萘洛尔降低肝硬化门静脉高压效果的对照研究[J].浙江医学,2012,34(24):1973-1975.
    [81]SINAGRA E,PERRICONE G,D'AMICO M,et al.Systematic review with meta-analysis:the haemodynamic effects of carvedilol compared with propranolol for portal hypertension in cirrhosis[J].Aliment Pharmacol Ther,2014,39(6):557-568.
    [82]HOBOLTH L,BENDTSEN F,HANSEN EF,et al.Effects of carvedilol and propranolol on circulatory regulation and oxygenation in cirrhosis:a randomised study[J].Dig Liver Dis,2014,46(3):251-256.
    [83]SERSTT,MELOT C,FRANCOZ C,et al.Deleterious effects of beta-blockers on survival in patients with cirrhosis and refractory ascites[J].Hepatology,2010,52(3):1017-1022.
    [84]FAN CL,DING HG.Research advances in selectiveβ-receptor blockers in prevention of esophagogastric variceal bleeding induced by liver cirrhosis[J].Nat Med J China,2013,93(6):474-476.(in Chinese)范春蕾,丁惠国.非选择性β受体阻滞剂预防肝硬化食管胃静脉曲张出血研究进展[J].中华医学杂志,2013,93(6):474-476.
    [85]GIANNELLI V,LATTANZI B,THALHEIMER U,et al.Betablockers and cirrhosis[J].Annl Gastroentol,2014,27(1):20-26.
    [86]GONZLEZ-ABRALDES J,ALBILLOS A,BAARES R,et al.Randomized comparison of long-term losartan versus propranolol in lowering portal pressure in cirrhosis[J].Gastroenterology,2001,121(2):382-388.
    [87]WONG F,NADIM MK,KELLUM JA,et al.Working party proposal for a revised classification system of renal dysfunction in patients with cirrhosis[J].Gut,2011,60(5):702-709.
    [88]ANGELI P,GINES P,WONG F,et al.Diagnosis and management of acute kidney injury in patients with cirrhosis:revised consensus recommendations of the International Club of Ascites[J].Gut,2015,64(4):531-537.
    [89]DING SH,LIU J,WANG JP.Efficacy ofβ-adrenergic blocker plus 5-isosorbide mononitrate and endoscopic band ligation for prophylaxis of esophageal variceal rebleeding:a meta-analysis[J].World J Gastroenterol,2009,15(17):2151-2155.
    [90]LUO W,MENG Y,JI HL,et al.Spironolactone lowers portal hypertension by inhibiting liver fibrosis,ROCK-2 activity and activating NO/PKG pathway in the bile-duct-ligated rat[J].PLoS One,2012,7(3):e34230.
    [91]TSIEN CD,RABIE R,WONG F.Acute kidney injury in decompensated cirrhosis[J].Gut,2013,62(1):131-137.
    [92]LO GH.The optimal interval of endoscopic variceal ligation:an issue of controversy[J].Gastrointest Endosc,2015,81(3):774.
    [93]KUMAR A,JHA SK,SHARMA P,et al.Addition of propranolol and isosorbide mononitrate to endoscopic variceal ligation does not reduce variceal rebleeding incidence[J].Gastroenterology,2009,137(3):892-901.
    [94]FUNAKOSHI N,SGALAS-LARGEY F,DUNY Y,et al.Benefit of combinationβ-blocker and endoscopic treatment to prevent variceal rebleeding:a meta-analysis[J].World J Gastroenterol,2010,16(47):5982-5992.
    [95]PUENTE A,HERNNDEZ-GEA V,GRAUPERA I,et al.Drugs plus ligation to prevent rebleeding in cirrhosis:an updated systematic review[J].Liver Int,2014,34(6):823-833.
    [96]CHEN W,LUO M,SUN YW,et al.Function of portal pressure during operation on the choice of surgical approaches in portal hypertension[J].Chin J Surg,2008,46(22):1703-1706.(in Chinese)陈炜,罗蒙,孙勇伟,等.术中门静脉压力动态测定在门静脉高压症术式选择中的作用[J].中华外科杂志,2008,46(22):1703-1706.
    [97]ZENG DB,DAI CZ,LU SC,et al.Abnormal splenic artery diameter/hepatic artery diameter ratio in cirrhosis-induced portal hypertension[J].World J Gastroenterol,2013,19(8):1292-1298.
    [98]MISHRA SR,CHANDER SHARMA B,KUMAR A,et al.Endoscopic cyanoacrylate injection versus beta-blocker for secondary prophylaxis of gastric variceal bleed:a randomised controlled trial[J].Gut,2010,59(6):729-735.
    [99]ORLOFF MJ,HYE RJ,WHEELER HO,et al.Randomized trials of endoscopic therapy and transjugular intrahepatic portosystemic shunt versus portacaval shunt for emergency and elective treatment of bleeding gastric varices in cirrhosis[J].Surgery,2015,157(6):1028-1045.
    [100]KOCHHAR GS,NAVANEETHAN U,HARTMAN J,et al.Comparative study of endoscopy vs transjugular intrahepatic portosystemic shunt in the management of gastricvariceal bleeding[J].Gastroenterol Rep(Oxf),2015,3(1):75-82.
    [101]JOO HS,JANG JY,EUN SH,et al.Long-term results of endoscopic histoacryl(N-butyl-2-cyanoacrylate)injection for treatment of gastric varices——a 10-year experience[J].Korean J Gastroenterol,2007,49(5):320-326.
    [102]KANG EJ,JEONG SW,JANG JY,et al.Long-term result of endoscopic Histoacryl(N-butyl-2-cyanoacrylate)injection for treatment of gastric varices[J].World J Gastroenterol,2011,17(11):1494-1500.
    [103]SARIN SK,KUMAR A.Endoscopic treatment of gastric varices[J].Clin Liver Dis,2014,18(4):809-827.
    [104]Chinese Society of Hepatology and Chinese Society of Infectious Diseases Chinese,Medical Association.The guideline of prevention and treatment for chronic hepatitis B:a 2015 update[J].J Clin Hepatol,2015,31(12):1941-1960.(in Chinese)中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2015年更新版)[J].临床肝胆病杂志,2015,31(12):1941-1960.
    [105]Chinese Society of Hepatology and Chinese Society of Infectious Diseases,Chinese Medical Association.The guideline of prevention and treatment for hepatitis C:a 2015 update[J].J Clin Hepatol,2015,31(12):1961-1979.(in Chinese)中华医学会肝病学分会,中华医学会感染病学分会.丙型肝炎防治指南(2015年更新版)[J].临床肝胆病杂志,2015,31(12):1961-1979.
    [106] AASLD/IDSA HCV Guidance Panel.Hepatitis C guidance:AASLD-IDSA recommendations for testing,managing,and treating adults infected with hepatitis C virus[J].Hepatology,2015,62(3):932-954.
    [107]LIU C,JIANG CM,LIU CH,et al.Effect of Fuzhenghuayu decoction on vascular endothelial growth factor secretion in hepatic stellate cells[J].Hepatobiliary Pancreat Dis Int,2002,1(2):207-210.
    [108]GU J,ZHANG Q,XUE D,et al.A randomized controlled study of fuzheng huayu capsule for prevention of esophageal variceal bleeding in patients with liver cirrhosis[J].Evid Based Complement Alternat Med,2013,2013:534960.
    [109]JIANG YF,MA J,HE B,et al.Function of portal pressure during operation on the choice of surgical approaches in portal hypertension[J].Chin J Hepatol,2012,20(5):344-347.(in Chinese)蒋永芳,马静,贺波,等.阿德福韦酯联合安络化纤丸治疗慢性乙型肝炎的疗效[J].中华肝脏病杂志,2012,20(5):344-347.
    [110]WU G,HE HY,LI Y,et al.Clinical effect of combination therapy with Fufang Biejia Ruangan tablet and entecavir in patients with hepatitis B virus-related cirrhosis[J].Chin J Hepatol,2014,22(8):604-608.(in Chinese)吴刚,何鸿雁,李烨,等.复方鳖甲软肝片联合恩替卡韦对HBV相关肝硬化患者的临床疗效观察[J].中华肝脏病杂志,2014,22(8):604-608.
    [111]VOROBIOFF JD,GROSZMANN RJ.Prevention of portal hypertension:from variceal development to clinical decompensation[J].Hepatology,2015,61(1):375-381.
    [112]IRANMANESH P,VAZQUEZ O,TERRAZ S,et al.Accurate computed tomography-based portal pressure assessment in patients with hepatocellular carcinoma[J].J Hepatol,2014,60(5):969-974.
    [113]LI L,LIU W,CHEN YH,et al.Antiviral drug resistance increases hepatocellular carcinoma:a prospective decompensated cirrhosis cohort study[J].World J Gastroenterol,2013,19(45):8373-8381.
    [114]GUO LH,XU HX.Contrast-enhanced ultrasound in the diagnosis of hepatocellular carcinoma and intrahepatic cholangiocarcinoma:controversy over the ASSLD guideline[J].Biomed Res Int,2015,2015:349172.
    [115]GUPTA N,KUMAR A,SHARMA P,et al.Effects of the adjunctive probiotic VSL#3 on portal haemodynamics in patients with cirrhosis and large varices:a randomized trial[J].Liver Int,2013,33(8):1148-1157.
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