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首页> 外文期刊>World Journal of Gastroenterology >Management of digestive bleeding related to portal hypertension in cirrhotic patients: A French multicenter cross-sectional practice survey.
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Management of digestive bleeding related to portal hypertension in cirrhotic patients: A French multicenter cross-sectional practice survey.

机译：肝硬化患者与门脉高压相关的消化性出血的处理：法国多中心横截面实践调查。

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AIM: To investigate the conformity of management practices of gastrointestinal hemorrhage in cirrhotic patients with relevant guidelines. METHODS: A questionnaire on the management of digestive bleeding was completed for all consecutive cirrhotic patients admitted to 31 French hospitals. RESULTS: One hundred and twenty-six bleeding events were recorded. It was the first bleeding episode in 79 patients (63%), of whom 40 (51%) had a prior diagnosis of cirrhosis and 25 (32%) had previously undergone an endoscopy. The bleeding episode was a recurrence in 46 patients (37%). The median time between onset and admission was 4 h, but exceeded 12 h in 42% of cases. There was an agreement between centers for early vasoactive drug administration (87% of cases), association with ligation (42%) more often than sclerosis (21%) at initial endoscopy, and antibiotic prophylaxis (64%). By contrast, prescription of beta-blockade alone or in combination (0 to 100%, P = 0.003) for secondary prophylaxis and lactulose (26% to86%, P = 0.04), differed among centers. CONCLUSION: In French hospitals, management of bleeding related to portal hypertension in cirrhotic patients is generally in keeping with the consensus. Broad variability still remains concerning beta-blockade use for secondary prophylaxis. Screening for esophageal varices, the use of antibiotic prophylaxis and patients information need to be improved.
机译：目的：探讨肝硬化患者消化道出血的管理实践与相关指南的符合性。方法：完成了对法国31所医院中所有连续性肝硬化患者的消化性出血管理问卷。结果：共记录126次出血事件。这是79例患者（63％）的首次出血事件，其中40例（51％）曾被诊断为肝硬化，25例（32％）曾接受内镜检查。出血发作在46例患者中复发（37％）。发病至入院的中位时间为4小时，但在42％的病例中超过12小时。在早期血管活性药物治疗中心（87％的案例）之间达成了协议，在初次内窥镜检查时，结扎的相关性（42％）比硬化症（21％）更频繁，抗生素的预防（64％）。相比之下，在各个中心，单独或联合使用β受体阻滞剂（0至100％，P = 0.003）和乳果糖的处方（26％至86％，P = 0.04）有所不同。结论：在法国医院，肝硬化患者门脉高压相关的出血处理通常与共识一致。关于β受体阻滞剂在二级预防中的应用，仍存在广泛的差异。食管静脉曲张的筛查，抗生素预防的使用和患者信息有待改进。

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