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标题: 知识有关静脉曲张无创诊断测试肝硬化：问卷调查，辽宁省 [打印本页]

作者: StephenW 时间: 2015-7-10 16:30 标题: 知识有关静脉曲张无创诊断测试肝硬化：问卷调查，辽宁省

本帖最后由 StephenW 于 2015-7-10 16:34 编辑

Knowledge about non-invasive diagnostic tests for varices in liver cirrhosis: A questionnaire survey to the Gastroenterology Branch of the Liaoning Medical Association, China
http://gastro.oxfordjournals.org/content/early/2015/07/09/gastro.gov031.full

+ Author Affiliations

Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, Liaoning, China

↵*Corresponding author. Department of Gastroenterology, General Hospital of Shenyang Military Area, No. 83 Wenhua Road, Shenyang, Liaoning 110840, China. Tel: +86-24-28897603; Fax: +86-24-28851113; Email: [email protected]

Received May 14, 2015.
Revision received June 2, 2015.
Accepted June 8, 2015.

Abstract

Background and aims: Due to the invasiveness of upper gastrointestinal endoscopy, non-invasive diagnostic tests for varices in liver cirrhosis have been widely established by numerous studies. A questionnaire survey, which was aimed at understanding the current knowledge about non-invasive diagnostic tests for varices in liver cirrhosis, was distributed among the members of Gastroenterology Branch of the Liaoning Medical Association.

Methods: A questionnaire assessing the knowledge about non-invasive diagnostic tests for varices was sent to 42 members who participated in the entire ninth committee. They were from 33 hospitals in 13 cities of Liaoning Province, China.

Results: Overall, 97.6% (41/42) of participants responded to the questionnaire. A majority of participants were chief physicians (85.4%), had >20 years of experience in clinical work of digestive diseases (80.5%) and worked at tertiary hospitals (97.6%). In 46.3% of participants’ departments, there were >200 patients with liver cirrhosis and gastroesophageal varices admitted every year. In 90.2% of participants’ departments, upper gastrointestinal endoscopy was regularly employed for the diagnosis of gastroesophageal varices. Only six (15%) participants often used non-invasive diagnostic tests for varices in clinical practice. Thirty (75%) participants knew at least one non-invasive diagnostic test for varices. The knowledge of at least one non-invasive diagnostic test was significantly associated with the number of cirrhotic patients with varices (P = 0.038) or the regular use of gastrointestinal endoscopy to diagnose varices (P = 0.022).

Conclusions: This questionnaire survey suggested that non-invasive diagnostic tests for varices in liver cirrhosis were rarely or never used in clinical practices in Liaoning Province, China. Reliable, non-invasive indexes should be further explored in a well-designed multi-center observational study.

Key words

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

作者: StephenW 时间: 2015-7-10 16:31

知识有关静脉曲张无创诊断测试肝硬化：问卷调查，辽宁省医学会，中国的胃肠科

兴顺齐，钟国*，李宏宇，刘旭和韩凳

+
作者机构

肝硬化研究小组，消化内科，沉阳军区，沉阳，辽宁，中国总医院

↵*通讯作者。消化内科，沉阳军区，文化路83号，沉阳，辽宁110840，中国总医院。联系电话：+ 86-24-28897603;传真：+ 86-24-28851113;电子邮件：[email protected]

收到2015年5月14日。
修订收到2015年6月2日。
接受2015年6月8日。

抽象

背景和目的：由于上消化道内镜检查的侵袭，对于肝硬化静脉曲张非侵入性诊断试验已广泛被许多研究确定。问卷调查，其目的是了解有关在肝硬化静脉曲张无创诊断测试的现有知识，为分布在辽宁省医学会消化病分会的成员之一。

方法：采用问卷评估有关静脉曲张无创诊断测试的知识被送到42名成员谁参加了整个第九届委员会委员。他们分别来自33家医院在中国辽宁省的13个城市。

结果：总体而言，97.6％（41/42），参与者回答了问卷。大多数参与者为主任医师（85.4％），有“20年的消化系统疾病（80.5％）的临床工作经验，并曾在三级医院（97.6％）。在参与者的部门46.3％，有> 200例肝硬化患者和胃静脉曲张每年录取。在参与者的部门90.2％，上消化道内镜检查，定期用于胃静脉曲张的诊断。只有六个（15％）的参与者通常使用的非侵入性诊断试验在临床实践中静脉曲张。三十（75％）参与者知道为静脉曲张的至少一种非侵入性的诊断测试。至少一种非侵入性的诊断测试的知识与肝硬化患者的静脉曲张的数量（p = 0.038）或经常使用消化道内镜检查的诊断静脉曲张性（P = 0.022）中的显著相关联。

结论：该问卷调查表明，在肝硬化静脉曲张无创诊断测试在辽宁省，中国的临床实践中很少或从未使用过。可靠的，非侵入性的指标应进一步探讨在一个精心设计的多中心观察研究。
关键词

肝硬化静脉曲张门脉高压的非侵入性诊断测试问卷调查

©该作者（S）2015年出版由牛津大学出版社和消化系统科学出版社有限责任公司。

这是根据知识共享署名许可（http://creativecommons.org/licenses/by/4.0/），允许在任何媒介无限制再利用，分布和繁殖的条款分发开放存取物品，提供的原创作品正确引用。

作者: 682256 时间: 2015-7-15 08:58

非侵入性肝硬化静脉曲张的临床诊断有哪几种？

作者: 682256 时间: 2015-7-15 09:02

本文说，肝硬化静脉曲张的非侵入性诊断的技术，在辽宁省用的很少。是什么原因？是设备问题，还是新技术手段还没有完全推广？

作者: 9病成医 时间: 2015-7-15 10:25

是通过检测肝内静脉曲张的程度，来判断肝硬化的程度吗？

作者: 682256 时间: 2015-7-15 11:27

9病成医发表于 2015-7-15 10:25
是通过检测肝内静脉曲张的程度，来判断肝硬化的程度吗？

有可能，本文主意是无创伤性检测普及率低，可能是希望普及率高一些的建议。

作者: 682256 时间: 2015-7-15 11:29

肝硬化病人易吐血，可能是这个原因？

作者: 9病成医 时间: 2015-7-15 16:20

682256 发表于 2015-7-15 11:27
有可能，本文主意是无创伤性检测普及率低，可能是希望普及率高一些的建议。 ...

当下，无创伤性检测肝硬化程度的“飞波”检查，已经很普遍了，但准确度、精确度不好说，是不是这种通过检测静脉曲张的办法比飞波更有优势？

作者: StephenW 时间: 2015-7-15 21:16

http://www.ncbi.nlm.nih.gov/pmc/ ... /DM31-03-954812.pdf

Non-Invasive Diagnostic and Prognostic Evaluation of Liver Cirrhosis and Portal Hypertension
Annalisa Berzigotti, 1 , 2 ,* Eyal Ashkenazi, 1 Enric Reverter, 1 Juan G. Abraldes, 1 and Jaime Bosch 1
Author information ► Article notes ► Copyright and License information ►
This article has been cited by other articles in PMC.
Abstract

Cirrhosis is the final stage of most of chronic liver diseases, and is almost invariably complicated by portal hypertension, which is the most important cause of morbidity and mortality in these patients. This review will focus on the non-invasive methods currently used in clinical practice for diagnosing liver cirrhosis and portal hypertension. The first-line techniques include physical examination, laboratory parameters, transient elastography and Doppler-US. More sophisticated imaging methods which are less commonly employed are CT scan and MRI, and new technologies which are currently under evaluation are MR elastography and acoustic radiation force imaging (ARFI). Even if none of them can replace the invasive measurement of hepatic venous pressure gradient and the endoscopic screening of gastroesophageal varices, they notably facilitate the clinical management of patients with cirrhosis and portal hypertension, and provide valuable prognostic information.
非侵入性诊断和肝硬化门脉高压的预后评估
安纳利萨Berzigotti，1，2，*的Eyal阿什肯纳泽，1安瑞科复归，1胡安G. Abraldes，1和Jaime博世1
作者信息►文章指出►版权和许可证信息►
这篇文章已被引用在PMC的其他文章。
抽象

肝硬化是大多数慢性肝病的最后阶段，并且几乎总是由门静脉高压症，这是发病率和死亡率在这些患者中的最重要的原因复杂。本次审查将侧重于目前使用在临床实践中诊断肝硬化门静脉高压的非侵入性的方法。一线技术包括体格检查，实验室指标，瞬时弹性成像和多普勒美。这是不太常用的更复杂的成像方法是CT扫描和核磁共振，以及新技术这是目前正在评估的MR弹性成像和声学辐射力成像（ARFI）。即使没有人可以替代肝静脉压力梯度和胃静脉曲张内镜筛查的侵入式测量，他们主要是方便患者的肝硬化门脉高压症的临床管理，并提供有价值的预后信息。

作者: x321 时间: 2015-7-16 00:54

SW大哥，我大姨是结肠癌转移到肝脏，复发开始疼痛。她以前是小三阳携带，现在肝复水了，请问有没有好的治疗方法？各位大神帮忙出出主意吧，先谢谢大家！

作者: StephenW 时间: 2015-7-16 12:22

回复 x321 的帖子

很遗憾听到你大姨的结肠癌转移到肝脏.如果手术是一个选项，这是生存的最好机会.其他标准方法:
射频治疗烧蚀（RFA）
化疗
选择性体内放射疗法（SIRT）

https://www.bowelcanceraustralia.org/liver-metastases

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