Журнал «Медицина неотложных состояний» Том 18, №8, 2022

Варикозне розширення стравохідних і шлункових вен є основним клінічним проявом цирозу печінки та портальної гіпертензії. Кровотеча з варикозно розширених вен шлунка зазвичай є тяжкою і пов’язана з вищою смертністю та більшим ризиком повторної кровотечі, ніж при стравохідних вариксах. Лікування варикозної кровотечі є складним і часто вимагає мультидисциплінарного підходу, що включає фармакологічні, ендоскопічні та радіологічні втручання. З точки зору лікування можна розглянути три етапи: первинна профілактика, активна кровотеча та вторинна профілактика. Основною метою первинної та вторинної профілактики є запобігання варикозній кровотечі. Однак активна варикозна кровотеча вимагає швидкого втручання для її зупинки та досягнення тривалого гемостазу. У цьому огляді описані особливості фармакологічного, ендоскопічного та інтервенційного радіологічного варіантів профілактики та лікування кровотеч зі шлункових вариксів. Пошук літератури здійснювався в базі даних MedLine на платформі PubMed.

Gastro-oesophageal varices are the major clinical manifestations of cirrhosis and portal hypertension. Bleeding from gastric varices is usually severe and is associated with higher morta­lity and a higher risk of rebleeding than from esophageal varices. The management of variceal bleeding is complex, often requiring a multidisciplinary approach involving pharmacological, endoscopic, and radiological interventions. In terms of treatment, three stages can be considered: primary prophylaxis, active bleeding, and secondary prophylaxis. The main goal of primary and secondary prophylaxis is to prevent variceal bleeding. However, active variceal bleeding is a medical emergency that requires prompt intervention to stop it and achieve long-term hemostasis. This review describes the features of pharmacological, endoscopic and interventional radiological prophylactic and treatment options in gastric variceal bleeding. We searched the literature in the MedLine database on the PubMed platform.

портальна гіпертензія; варикозно розширені вени шлунка; кровотеча; профілактика; лікування

portal hypertension; gastric varices; bleeding; prophylaxis; treatment

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