Nepřihlášený uživatel
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Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2017; 71(2): 105–116. doi:10.14735/amgh2017105.

Léčba krvácení v důsledku portální hypertenze při jaterní cirhóze – aktualizace doporučených postupů ČHS ČLS JEP

Tomáš Fejfar, Tomáš Vaňásek, Radan Brůha, Petr Hůlek, Vlastimil Procházka, Jaromír Petrtýl, Jan Lata

Souhrn

Varikózní krvácení je nejzávažnější a potenclně smrtící komplikací portální hypertenze. Adekvátní léčebný postup sestává ze zajištění nemocného volumexpanzí a hemosubstitucí, antibiotické profylaxe a zejména z podávání vazoaktivní léčby spolu s endoskopickým ošetřením. V případě selhání je indikována transjugulární intrahepatální portosystémová spojka. Jako most k transjugulární intrahepatální portosystémové spojce či v případě její kontraindikace se zavádí dedikovaný jícnový stent (Danis) nebo balonková sonda. V primární a sekundární profylaxi se uplatňuje léčba neselektivním β-blokátorem a endoskopická léčba. Následující článek přináší aktualizaci doporučení České hepatologické společnosti pro tuto léčbu.

Klíčová slova

krvácení, léčba, portální hypertenze

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