Principles of portal hypertension treatment at patients with liver cirrhosis
The aim of review. To describe modern principles of portal hypertension treatment in patients with liver cirrhosis (LC).Original positions. One of the most significant LC complications is portal hypertension - acute bleeding from varicose veins (VV) of the esophagus and the stomach, ascites, hepator...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | Russian |
| Published: |
Gastro LLC
2012-09-01
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| Series: | Российский журнал гастроэнтерологии, гепатологии, колопроктологии |
| Subjects: | |
| Online Access: | https://www.gastro-j.ru/jour/article/view/1322 |
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| Summary: | The aim of review. To describe modern principles of portal hypertension treatment in patients with liver cirrhosis (LC).Original positions. One of the most significant LC complications is portal hypertension - acute bleeding from varicose veins (VV) of the esophagus and the stomach, ascites, hepatorenal syndrome. VV bleeding is a critical state at which 15–20% of patients die within subsequent 6 wks. Patients with acute episode of bleeding require treatment by vasoconstrictors, antibiotics in combination to endoscopic methods of treatment. For bleeding prophylaxis β-adrenoblockers, endoscopic procedures are used. Hepatorenal syndrome is associated to infections most often. Without treatment or liver transplantation patients with hepatorenal syndrome of the 1st type live for no more than 2 wks. Vasoconstrictors in combination to albumin are drugs of choice for these patients. Prophylaxis requires careful monitoring for other complications of cirrhosis, compensation of liver function.Conclusion. Patients with liver cirrhosis and portal hypertension are severe patients. Life prognosis most often is determined by infections and associating renal failure (hepatorenal syndrome), esophageal varices bleedings. As the major part of these states peripheral vasodilation, prescription of vasoconstrictors (first of all — terlipressin) is pathogenically justified and results in arrest of acute bleedings from esophageal VV, and in functional recovery of kidneys at renal failure. |
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| ISSN: | 1382-4376 2658-6673 |