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Журнал «Медицина неотложных состояний» Том 18, №5, 2022

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Ендоскопічне лікування кровотеч із варикозно розширених вен шлунка

Авторы: Чуклін С.М. (1), Чуклін С.С. (2), Дутка Я.Р. (1)
(1) — Львівський національний медичний університет імені Данила Галицького, м. Львів, Україна
(2) — Медичний центр Святої Параскеви, м. Львів, Україна

Рубрики: Медицина неотложных состояний

Разделы: Справочник специалиста

Версия для печати


Резюме

Кровотеча з варикозно розширених вен стравоходу та шлунка є найнебезпечнішим для життя ускладненням цирозу печінки та портальної гіпертензії. Кровотеча з варикозно розширених вен шлунка часто є серйознішою та може призвести до смерті. Для її зупинки спочатку проводиться ендоскопічне лікування. Зараз міжнародні консенсусні рекомендації щодо лікування кровотечі з варикозу шлунка відрізняються залежно від ендоскопічної класифікації. Варикозне розширення вен шлунка має іншу фізіологію та клінічні характеристики порівняно з варикозним розширенням вен стравоходу. Існує мало інформації про способи гемостазу при кровотечі зі шлункових вариксів. Незважаючи на те, що кілька нещодавніх розробок щодо препаратів і методів поліпшили результати при цій патології, консенсус щодо оптимального лікування не досягнутий. У цій статті розглядаються сучасні можливості ендоскопічного втручання при варикозній кровотечі зі шлунка за літературними даними з бази MedLine.

Bleeding from esophageal and gastric varices is the most life-threatening complication of liver cirrhosis and portal hypertension. Gastric variceal bleeding is often more serious and can be fatal. Endoscopic treatment is initially performed to stop variceal hemorrhage. Currently, international consensus guidelines for the treatment of gastric variceal bleeding vary depending on the endoscopic classification. Gastric varices have different physiology and clinical characteristics compared to esophageal varices. There is little information about the management of gastric variceal bleeding. Although several recent developments in the agents and the techniques have improved the outcome in this pathology, no consensus has been reached on the optimum treatment. This article reviews the current endoscopic treatment modalities used in gastric variceal bleeding according to the literature from MedLine.


Ключевые слова

варикозно розширені вени шлунка; огляд; класифікація; ендоскопія; лікування

gastric varices; review; classification; endoscopy; treatment


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