Management of digestive bleeding related to portal hypertension in cirrhotic patients:A French multicenter cross-sectional practice survey

作     者：Pierre Ingrand Jérme Gournay Pierre Bernard Frédéric Oberti Brigitte Bernard-Chabert Arnault Pauwels Philippe Renard Eric Bartoli Jean-Franois Cadranel Jean-Claude Barbare Isabelle Ingrand Michel Beauchant 

作者机构：Clinical Research Center Poitiers University France Hepato-Gastroenterology Centre Hospitalier Universitaire Nantes France Hepato-Gastroenterology Centre Hospitalier Universitaire Saint-André Bordeaux France Hepato-Gastroenterology Centre Hospitalier Universitaire Angers France Hepato-Gastroenterology Centre Hospitalier Universitaire Reims France Hepato-Gastroenterology Centre Hospitalier Gonesse France Hepato-Gastroenterology Centre Hospitalier Argenteuil France Hepato-Gastroenterology Centre Hospitalier Universitaire Amiens France Hepato-Gastroenterology Centre Hospitalier Creil France Hepato-Gastroenterology Centre Hospitalier Compiègne France Hepato-Gastroenterology Centre Hospitalier Universitaire Poitiers France 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2006年第12卷第48期

页      面：7810-7814页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Supported by grants from the French Society of Gastroenterology 

主　　题：Digestive bleeding Portal hypertension Cirrhosis Evaluation studies 

摘      要：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 forearly 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% to 86%, 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.