Nationwide survey analysis of esophagogastric varices in portal hypertension based on endoscopic management in China  

作　　者：Xing Wang Bing Hu Yiling Li Weichun Lin Zhijie Feng Yanjing Gao Zhining Fan Feng Ji Bingrong Liu Jinhai Wang Wenhui Zhang Tong Dang Hong Xu Derun Kong Lili Yuan Liangbi Xu Shengjuan Hu Liangzhi Wen Ping Yao Yunxiao Liang Xiaodong Zhou Huiling Xiang Xiaowei Liu Xiaoquan Huang Yinglei Miao Xiaoliang Zhu De‐An Tian Feihu Bai Jitao Song Ligang Chen Yangzhen Bian Ba Yingcai Ma Yifei Huang Bin Wu Xiaolong Qi CHESS‐Endoscopyconsortium 

机构地区：[1]Department of Gastroenterology,The Third Affiliated Hospital of Sun Yat‐sen University,Guangzhou,Guangdong,China [2]Guangdong Province Engineering and Technology Research Center of Digestive Endoscopy,Guangzhou,Guangdong,China [3]Department of Gastroenterology and Hepatology,West China Hospital of Sichuan University,Chengdu,Sichuan,China [4]Department of Gastroenterology,The First Affiliated Hospital of China Medical University,Shenyang,Liaoning,China [5]Department of Gastroenterology,The Second Hospital of Hebei Medical University,Shijiazhuang,Hebei,China [6]Department of Gastroenterology,Qilu Hospital of Shandong University,Jinan,Shandong,China [7]Department of Digestive Endoscopy,The First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu,China [8]Department of Gastroenterology,The First Affiliated Hospital of Zhejiang University,Hangzhou,Zhejiang,China [9]Department of Gastroenterology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan,China [10]Department of Gastroenterology,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi,China [11]Department of Gastroenterology,Beijing Daxing District People's Hospital,Beijing,China [12]Department of Gastroenterology,The Second Affiliated Hospital of Baotou Medical College,Baotou,Inner Mongolia,China [13]Department of Gastroenterology,The First Hospital of Jilin University,Changchun,Jilin,China [14]Department of Gastroenterology,The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui,China [15]Department of Digestive Endoscopy,The Second Hospital of Shanxi Medical University,Taiyuan,Shanxi,China [16]Digestive Endoscopy Center,The Affiliated Hospital of Guizhou Medical University,Guiyang,Guizhou,China [17]Department of Gastroenterology,People's Hospital of Ningxia Hui Autonomous Region,Ningxia Medical University,Yinchuan,Ningxia,China [18]Department of Gastroenterology,Daping Hospital,Army Medical University,Chongqing,China [19]Department of Gastroenterology,The First Affiliated Hospital of Xinji

出　　处：《Portal Hypertension & Cirrhosis》2024年第3期129-138,共10页门静脉高压与肝硬化（英文）

基　　金：National Natural Science Foundation of China,Grant/Award Number:82070574;Natural Science Foundation of Guangdong Province Team Project,Grant/Award Number:2018B030312009;Tianjin Health Research Project,Grant/Award Number:TJWJ2022XK029;Tianjin Key Medical Discipline(Specialty)Construction Project,Grant/Award Number:TJYXZDXK-034A。

摘　　要：Aims:The endoscopic treatment of esophagogastric varices is challenging,and the nationwide application of endoscopic therapies for various types of esophagogastric varices and different clinical scenarios remains unclear.This study investigated the use of endoscopic therapy for portal hypertension in China.Methods:This study used a questionnaire survey initiated by the Liver Health Consortium in China to investigate the use of endoscopic therapies for portal hypertension.Questionnaires were released online from January 30,2023 to February 28,2023 and filled out by chief physicians or senior instructors responsible for endoscopic therapies in participating hospitals across 31 provinces(autonomous regions and municipalities)in China.Comparisons of guideline adherence between primary and referral medical centers were performed using the chi‐square test or Fisher's exact test.Results:In total,836 hospitals participated in the survey.For primary and secondary prophylaxis of esophagogastric variceal bleeding(EGVB),adherence to the national guidelines was 72.5%(606/836)and 39.2%(328/836),respectively.Significant differences were observed in the rate of adherence between the primary and referral centers for primary(79.9%[111/139]vs.71.0%[495/697],p=0.033)and secondary prophylaxis(27.3%[38/139]vs.41.6%[290/697],p=0.002).Of the hospitals,78.2%(654/836)preferred endoscopic therapies for acute EGVB,and the timing of endoscopy was usually within 12 h(48.5%,317/654)and 12-24 h(36.9%,241/654)after bleeding.Endoscopic therapy was more likely to be the first choice of treatment for acute EGVB in referral centers than in primary centers(82.6%[576/697]vs.56.1%[78/139],p<0.001).Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1,the most prevalent procedures were cyanoacrylate injection combined with sclerotherapy(48.2%[403/836]and 29.9%[250/836],respectively);however,substantial hospitals preferred clip-assisted therapies(12.4%[104/836]and 26.4%[221/836],respectively).Nonselective beta�

关 键 词：ENDOSCOPY esophagogastric varices guideline adherence portal hypertension questionnaire survey 

分 类 号：R656[医药卫生—外科学]