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Huan H, Liu C, Yang Z, Bao JL, Liu C, Wang JT, Zhang L, Wang CH, Ci RSP, Tu QL, Ren T, Xu D, Zhang HJ, Li XG, Kang N, Li XP, Wu YH, Pu X, Tan YJ, Cao JJ, Luo SWQ, Luo SQP, Zhuo M, Qi XL. [Current situation of screening, prevention and treatment of bleeding esophageal varices in cirrhotic portal hypertension in Tibet region: a multicenter study]. Zhonghua Gan Zang Bing Za Zhi 2020; 28:737-741. [PMID: 33053972 DOI: 10.3760/cma.j.cn501113-20200615-00318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Objective: To investigate and analyze the current situation, screening, clinical characteristics, prevention and treatment of bleeding esophageal varices in cirrhotic patients with portal hypertension in Tibet region. Methods: Clinical data of cirrhotic patients with portal hypertension through March 2017 to February 2020 from Tibet region were collected and analyzed retrospectively. Results: 511 cases with liver cirrhosis were included in the study, of which 185 cases (36.20%) had compensated cirrhosis and 326 cases (63.80%) had decompensated cirrhosis. Further analysis of the etiological data of liver cirrhosis showed that 306 cases (59.88%) were of chronic hepatitis B, 113 cases (22.11%) of alcoholic liver disease, and 68 cases (13.31%) of chronic hepatitis B combined with alcoholic liver disease. Among patients with compensated liver cirrhosis, 48 cases (25.95%) underwent endoscopic examination of which 33 diagnosed as high-risk variceal bleeding. However, none of these 33 cases had received non-selective β-blocker therapy, and only four patients had received endoscopic variceal banding therapy. Among patients with decompensated liver cirrhosis, 83 cases (25.46%) had a history of upper gastrointestinal bleeding, 297 cases (91.10%) had ascites, 23 cases (7.05%) had hepatic encephalopathy, and 3 cases (0.92%) had hepatorenal syndrome. Among the patients with a history of upper gastrointestinal bleeding, 42 cases (50.60%) had received secondary preventive treatment for bleeding esophageal varices, including 39 cases of endoscopic treatment, 1 case of endoscopic combined drug treatment, 3 cases of interventional treatment, and 2 cases of surgical treatment. Conclusion: Chronic hepatitis B and alcoholic liver diseases are the main causes of liver cirrhosis in Tibet region. Moreover, this region lacks screening, prevention and treatment for bleeding esophageal varices in cirrhotic patients with portal hypertension. Therefore, it is necessary to increase the screening of high-risk groups to prevent and improve the first-time bleeding, and promote multidisciplinary team to prevent and treat re-bleeding.
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Affiliation(s)
- H Huan
- Department of Gastroenterology, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu 610041, China
| | - C Liu
- Department of Gastroenterology, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu 610041, China
| | - Z Yang
- Department of Hepatology, The Third People's Hospital of Tibet Autonomous Region, Lasa 850000, China
| | - J L Bao
- Department of Gastroenterology,Shannan People's Hospital, Shannan 856000, China
| | - C Liu
- CHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - J T Wang
- CHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - L Zhang
- Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
| | - C H Wang
- Department of Gastroenterology, The Second People's Hospital of Tibet Autonomous Region, Lasa 850000, China
| | - R S P Ci
- Department of Internal Medicine, Naqu Tibetan Hospital, Naqu 852000, China
| | - Q L Tu
- Department of Gastroenterology, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu 610041, China
| | - T Ren
- Department of Gastroenterology, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu 610041, China
| | - D Xu
- CHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - H J Zhang
- CHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - X G Li
- CHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - N Kang
- CHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - X P Li
- Department of Gastroenterology, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu 610041, China
| | - Y H Wu
- Department of Gastroenterology, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu 610041, China
| | - X Pu
- Department of Gastroenterology, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu 610041, China
| | - Y J Tan
- Department of Gastroenterology, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu 610041, China
| | - J J Cao
- Medical Administration, Ali District Health and Safety Commission, Ali 859000, China
| | - S W Q Luo
- Department of Internal Medicine, Naqu Tibetan Hospital, Naqu 852000, China
| | - S Q P Luo
- Department of Pediatrics, Ali District People's Hospital, Ali 859000, China
| | - M Zhuo
- Department of Gastroenterology, Lasa People's Hospital, Lasa 850000, China
| | - X L Qi
- CHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou 730000, China
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