内镜治疗肝硬化患者上消化道早癌的风险及处理策略  

Risk associated with endoscopic treatment of early upper gastrointestinal cancer in patients with liver cirrhosis and management strategies

作　　者：谭玉勇[1,2,3] 卿毓敏 龚建 刘德良[1,2,3] Yu-Yong Tan;Yu-Min Qing;Jian Gong;De-Liang Liu(Department of Gastroenterology,Second Xiangya Hospital,Central South University,Changsha 410011,Hunan Province,China;Research Center of Digestive Diseases,Central South University,Changsha 410011,Hunan Province,China;Clinical Research Center for Digestive Diseases in Hunan Province,Changsha 410011,Hunan Province,China)

机构地区：[1]中南大学湘雅二医院消化内科,湖南省长沙市410011 [2]中南大学消化病研究中心,湖南省长沙市410011 [3]湖南省消化疾病临床医学研究中心,湖南省长沙市410011

出　　处：《世界华人消化杂志》2024年第2期102-108,共7页World Chinese Journal of Digestology

摘　　要：肝硬化患者患上消化道肿瘤风险增加,尤其是酒精性肝硬化患者.随着内镜检查的推广及普及,越来越多的上消化道早癌得以早期发现及治疗.内镜治疗已成为上消化道早癌的首选治疗方式,肝硬化患者由于可能存在血小板减少、凝血功能障碍、合并食管胃静脉曲张等情况,内镜治疗过程中出血、感染等风险较大.近年来国内外已有部分研究探讨内镜治疗肝硬化伴上消化道早癌的安全性及有效性.本文总结了近年来发表的内镜治疗肝硬化伴上消化道早癌的研究结果,简要综述其风险及防治策略,为临床提供指导.Patients with liver cirrhosis have an increased risk of upper gastrointestinal carcinomas,especially those with alcoholic cirrhosis.With the widespread use of endoscopic examination,more and more upper gastrointestinal carcinomas are found and treated at an early stage.Endoscopic resection is the first-line treatment for early upper gastrointestinal carcinomas.Patients with liver cirrhosis may have comorbid thrombocytopenia,coagulation dysfunction,gastroesophageal varices,et al,which may increase the risk of complications such as bleeding and infection.Recently,several studies concerning the efficacy and safety of endoscopic treatment of early esophageal/gastric cancer or precancerous lesions have been reported.In this review,we summarize the risk associated with endoscopic treatment of early upper gastrointestinal cancer in patients with liver cirrhosis and management strategies,aiming to providing useful tips for clinicians.

关 键 词：早期食管癌 早期胃癌 癌前病变 肝硬化 内镜治疗 食管胃静脉曲张 

分 类 号：R575.2[医药卫生—消化系统]