切换至 "中华医学电子期刊资源库"
高级检索
中华胃肠内镜电子杂志

中华胃肠内镜电子杂志 ›› 2022, Vol. 09 ›› Issue (03) : 138 -144. doi: 10.3877/cma.j.issn.2095-7157.2022.03.005

综述

胃窦血管扩张症的治疗进展
陈德鑫1, 翟亚奇1,†(), 李明阳1,†()   
  1. 1. 100853　北京，解放军总医院第一医学中心消化内科医学部
  • 收稿日期:2022-05-22 出版日期:2022-08-15
  • 通信作者: 翟亚奇, 李明阳

Research progress of gastric antral vascular ectasia

Dexin Chen1, Yaqi Zhai1,†(), Mingyang Li1,†()   

  1. 1. Department of Gastroenterology and Hepatology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
  • Received:2022-05-22 Published:2022-08-15
  • Corresponding author: Yaqi Zhai, Mingyang Li
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

陈德鑫, 翟亚奇, 李明阳. 胃窦血管扩张症的治疗进展[J/OL]. 中华胃肠内镜电子杂志, 2022, 09(03): 138-144.

Dexin Chen, Yaqi Zhai, Mingyang Li. Research progress of gastric antral vascular ectasia[J/OL]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2022, 09(03): 138-144.

胃窦血管扩张症(GAVE)是一种原因不明的、以胃窦黏膜条形或弥漫性毛细血管扩张为典型特征的血管畸形性疾病，约占非静脉曲张上消化道出血的4%。临床表现主要为缺铁性贫血和反复的消化道出血，胃镜多能确诊。GAVE的治疗方式主要包括药物、消化内镜和外科手术，目前尚无统一规范的治疗策略。近期，沙利度胺、贝伐珠单抗以及内镜下套扎术、射频术被用于GAVE的治疗，初步表现出令人满意的结果。因此，本文通过系统文献回顾，对GAVE的治疗进展作一综述。

关键词: 胃窦血管扩张症, 上消化道出血, 内窥镜, 治疗

Gastric antral vascular ectasia (GAVE) is a vascular malformation of unknown cause, characterized by strip or diffuse telangiectasia of gastric antral mucosa, which is usually diagnosed by gastroscopy. The main clinical manifestations are iron deficiency anemia and recurrent gastrointestinal bleeding. The major treatment of GAVE includes pharmacotherapy, endoscopy and surgery. Currently, no consensus has been reached on the management of GAVE. Recently, thalidomide and bevacizumab, as well as endoscopic ligation and radiofrequency ablation have been increasingly used in the management of GAVE, preliminarily showing promising results. Therefore, in this review, we reviewed the advances in the treatment of GAVE to provide authoritative clinical references for further treatment.

Key words: Gastric antral vascular ectasia, Upper gastrointestinal bleeding, Endoscopy
图1 线状条纹型GAVE
图2 弥漫点状型GAVE
表1 GAVE的药物治疗总结
药物 机制 用法用量 特点 不良反应
奥曲肽 减少内脏血流；抑制血管活性物质的分泌；降低胃肠道收缩性[53,74] 皮下注射，0.1 mg，2~3次/d或20 mg 1次/月[54]。 起效较快、副作用较少 恶心、腹痛、腹泻、轻度脂肪泻、腹胀[75]
环磷酰胺 抑制免疫[58] 每月750~ 1000 mg/m2，1次/月[58,76] 适用于合并SSc和/或大面积弥漫性GAVE患者[58] 感染，骨髓和膀胱毒性[77]
雌激素孕酮联合治疗 减少胃黏膜血管的数量及血流；增加血管紧张素和去甲肾上腺素的血管收缩作用；增加血管内皮的完整性[78,79,80] 30 u雌激素与1.5 mg孕酮长期维持治疗[81] 副作用少且较轻微；需长期维持 男性乳房发育、子宫出血等[79,82]
糖皮质激素 收缩血管，抑制血管生成，改善毛细血管脆性[66,83,84] 30 mg/d初始剂量，逐步减至10 mg/d维持[66] 适合合并自身免疫性疾病的GAVE患者[59] 免疫抑制、血糖升高、高脂血症、骨质疏松、股骨头坏死、消化道黏膜损伤和出血[85]
沙利度胺 抑制VEGF，抗血管生成[62] 100 mg/d，维持3个月以上[63] 作用缓慢；副作用轻微 便秘、疲劳、头晕、嗜睡、周围神经病变、水肿、皮疹以及深静脉血栓、胎儿畸型[62,63]
贝伐珠单抗 抑制VEGF，抗血管生成[64] 5 mg/kg[65] 抗血管生成作用强，用于难治性GAVE 高血压恶化、皮肤黏膜出血、动静脉血栓等[65]
氨甲环酸 抗纤溶药，治疗GAVE的具体机制不详 0.5~1 g，3次/d[70] 适用于合并明显活动性消化道出血的患者[86] 增加血栓风险，如心肌梗塞、肺栓塞及深静脉血栓[71]
[1]
Rider JA, Klotz AP, Kirsner JB.Gastritis with veno-capillary ectasia as a source of massive gastric hemorrhage[J]．Gastroenterology，1953，24(1): 118-123.
[2]
Jabbari M, Cherry R, Lough JO，et al.Gastric antral vascular ectasia：the watermelon stomach[J]．Gastroenterology，1984，87(5):1165-1170.
[3]
Kichloo A, Solanki D, Singh J，et al.Gastric Antral Vascular Ectasia：Trends of Hospitalizations，Biodemographic Characteristics, and Outcomes With Watermelon Stomach[J]．Gastroenterol Res, 2021，14(2):104-111.
[4]
Dulai GS, Jensen DM, Kovacs TO，et al.Endoscopic treatment outcomes in watermelon stomach patients with and without portal hypertension [J]．Endoscopy，2004，36(1):68-72.
[5]
Ward EM, Raimondo M, Rosser BG，et al.Prevalence and natural history of gastric antral vascular ectasia in patients undergoing orthotopic liver transplantation[J]．J Clin Gastroenterol，2004，38 (10):898-900.
[6]
Fouad M, Khalaf Fath-Elbab H, Mostafa AM，et al.Gastric antral vascular ectasia in hepatitis C virus related liver cirrhosis：Fetching for predictors [J]．JGH Open，2021，5(8):923-928.
[7]
Smith E, Davis J, Caldwell S．Gastric Antral Vascular Ectasia Pathogenesis and the Link to the Metabolic Syndrome[J]．Curr Gastroenterol Rep, 2018, 20(8):36.
[8]
McCarty TR, Rustagi T．Comparative Effectiveness and Safety of Radiofrequency Ablation Versus Argon Plasma Coagulation for Treatment of Gastric Antral Vascular Ectasia：A Systematic Review and Meta-Analysis[J]．J Clin Gastroenterol，2019，53(8):599-606.
[9]
Peng M, Guo X, Yi F，et al.Endoscopic treatment for gastric antral vascular ectasia[J]．Ther Adv Chronic Dis，2021，12: 20406223211039696.
[10]
Morris ML, Tucker RD, Baron TH，et al.Electrosurgery in gastrointestinal endoscopy：principles to practice[J]．Am J Gastroenterol，2009, 104(6): 1563-1574.
[11]
Bhatti MA, Khan AA, Alam A，et al.Efficacy of argon plasma coagulation in gastric vascular ectasia in patients with liver cirrhosis[J]．J Coll Physicians Surg Pak，2009，19(4):219-222.
[12]
Elhendawy M, Mosaad S, Alkhalawany W，et al.Randomized controlled study of endoscopic band ligation and argon plasma coagulation in the treatment of gastric antral and fundal vascular ectasia[J]．United Eur Gastroenterol J，2016，4(3):423-428.
[13]
Ripoll C, Garcia-Tsao G．Management of gastropathy and gastric vascular ectasia in portal hypertension[J]．Clin Liver Dis，2010, 14(2):281-295.
[14]
Nakamura S, Mitsunaga A, Konishi H，et al.Long-term follow up of gastric antral vascular ectasia treated by argon plasma coagulation[J]．Dig Endosc，2006，18(2):128-133.
[15]
Naga M, Esmat S, Naguib M，et al.Long-term effect of argon plasma coagulation (APC) in the treatment of gastric antral vascular ectasia (GAVE)[J]．Arab J Gastroenterol，2011，12(1):40-43.
[16]
Tamari H, Oka S, Tanaka S，et al.Clinical usefulness of combination therapy with polidocanol injection and argon plasma coagulation for gastric antral vascular ectasia[J]．JGH Open，2021，5(4):465-469.
[17]
Gross SA, Al-Haddad M, Gill KR，et al.Endoscopic mucosal ablation for the treatment of gastric antral vascular ectasia with the HALO90 system: a pilot study[J]．Gastrointest Endosc，2008，67(2): 324-327.
[18]
Magee C, Lipman G, Alzoubaidi D，et al.Radiofrequency ablation for patients with refractory symptomatic anaemia secondary to gastric antral vascular ectasia[J]．United Eur Gastroenterol J, 2019，7(2):217-224.
[19]
Raza N, Diehl DL.Radiofrequency ablation of treatment-refractory gastric antral vascular ectasia (GAVE)[J]．Surg Laparosc Endosc Percutan Tech, 2015，25(1):79-82.
[20]
Maida M, Camilleri S, Manganaro M，et al.Radiofrequency Ablation for Treatment of Refractory Gastric Antral Vascular Ectasia：A Systematic Review of the Literature[J]．Gastroenterol Res Pract, 2017，2017:5609647.
[21]
Markos P, Bilic B, Ivekovic H，et al.Radiofrequency ablation for gastric antral vascular ectasia and radiation proctitis[J]．Indian J Gastroenterol, 2017，36(2):145-148.
[22]
Jana T, Thosani N, Fallon MB，et al.Radiofrequency ablation for treatment of refractory gastric antral vascular ectasia (with video)[J]．Endosc Int Open，2015，3(2):E125-127.
[23]
McGorisk T, Krishnan K, Keefer L，et al.Radiofrequency ablation for refractory gastric antral vascular ectasia (with video)[J]．Gastrointest Endosc，2013，78(4):584-588.
[24]
Senzolo M, Realdon S, Simoncin B，et al.Endoscopic radiofrequency ablation for the treatment of gastric antral vascular ectasia in cirrhotic patients：A bi-centric clinical and economical cost-effective analysis[J]．J Hepatol，2018，68:S750-S751.
[25]
Dray X, Repici A, Gonzalez P, et al.Radiofrequency ablation for the treatment of gastric antral vascular ectasia[J]．Endoscopy，2014，46(11): 963-969.
[26]
Dunn JM, Boger P, Cheong E，et al.Radiofrequency ablation (RFA) is safe and effective for the treatment of gastric antral vascular ectasia refractory to APC-results of a national audit[J]．Gut，2015，64: A214.
[27]
Bozzi R, Bozzi F, Sannino M, et al. Rfa and gastric antral vascular ectasia: Results of our initial experience[J]．Dig Endosc，2017，29: 68-69.
[28]
McCarty TR, Rustagi T．New Indications for Endoscopic Radiofrequency Ablation[J]．Clin Gastroenterol Hepatol，2018，16 (7):1007-1017.
[29]
Magee C, Graham D, Leonard C, et al.The cost-effectiveness of radiofrequency ablation for treating patients with gastric antral vascular ectasia refractory to first line endoscopic therapy[J]．Curr Med Res Opin, 2020，36(6):977-983.
[30]
St Romain P, Boyd A, Zheng J，et al.Radiofrequency ablation (RFA) vs. argon plasma coagulation (APC) for the management of gastric antral vascular ectasia (GAVE) in patients with and without cirrhosis: results from a retrospective analysis of a large cohort of patients treated at a single center[J]．Endosc Int Open，2018，6(3): E266-E270.
[31]
O′Morain NR, O′Donovan H, Conlon C，et al.Is Endoscopic Band Ligation a Superior Treatment Modality for Gastric Antral Vascular Ectasia Compared to Argon Plasma Coagulation？[J]．Clin Endosc，2021，54(4): 548-554.
[32]
Tantau M, Crisan D．Is endoscopic band ligation the gold standard for gastric antral vascular ectasia？[J]．Endosc Int Open，2019，7(12):E1630-1631.
[33]
Kumar R, Mohindra S, Pruthi HS.Endoscopic band ligation：a novel therapy for bleeding gastric antral vascular ectasia[J]．Endoscopy, 2007, 39(Suppl 1): E56-57.
[34]
Sato T, Yamazaki K, Akaike J．Endoscopic band ligation versus argon plasma coagulation for gastric antral vascular ectasia associated with liver diseases[J]．Dig Endosc，2012，24(4):237-242.
[35]
Mohan BP, Toy G, Kassab LL，et al.Endoscopic band ligation in the treatment of gastric antral vascular ectasia：a systematic review and meta-analysis[J]．Gastrointest Endosc，2021，94(6):1021-1029,e10.
[36]
Fabian A, Bor R, Szabo E，et al.Endoscopic treatment of gastric antral vascular ectasia in real-life settings：Argon plasma coagulation or endoscopic band ligation？[J]．J Dig Dis，2021，22(1): 23-30.
[37]
Zepeda-Gomez S, Sultanian R, Teshima C，et al.Gastric antral vascular ectasia: a prospective study of treatment with endoscopic band ligation[J]. Endoscopy，2015，47(6):538-540.
[38]
McCarty TR, Hathorn KE, Chan WW，et al.Endoscopic band ligation in the treatment of gastric antral vascular ectasia: a systematic review and meta-analysis[J]．Endosc Int Open，2021，9(7):E1145-E1157.
[39]
Hirsch BS, Ribeiro IB, Funari MP，et al.Endoscopic Band Ligation Versus Argon Plasma Coagulation in the Treatment of Gastric Antral Vascular Ectasia：A Systematic Review and Meta-Analysis of Randomized Controlled Trials[J]．Clin Endosc，2021，54(5): 669-677.
[40]
Qiu H, Mao Y, Zeng J，et al.Vascular-targeted photodynamic therapy of gastric antral vascular ectasia (GAVE)[J]．J Photochem Photobiol B, 2017，166: 58-62.
[41]
毛永平，邱海霞，顾瑛，等．血管靶向光动力疗法治疗胃窦血管扩张症[J]．中国激光医学杂志，2010，19(4): 220-222,271.
[42]
Qiu H, Mao Y, Gu Y，et al.Vascular targeted photodynamic therapy for bleeding gastrointestinal mucosal vascular lesions：a preliminary study[J]. Photodiagn Photodyn Ther，2012, 9(2): 109-117.
[43]
Committee AT, Parsi MA, Trindade AJ，et al.Cryotherapy in gastrointestinal endoscopy[J]．Video GIE，2017，2(5): 89-95.
[44]
Kantsevoy SV, Cruz-Correa MR, Vaughn CA，et al.Endoscopic cryotherapy for the treatment of bleeding mucosal vascular lesions of the GI tract：a pilot study[J]．Gastrointest Endosc，2003，57(3): 403-406.
[45]
Patel AA, Trindade AJ, Diehl DL，et al.Nitrous oxide cryotherapy ablation for refractory gastric antral vascular ectasia[J]．United Eur Gastroenterol J，2018，6(8):1155-1160.
[46]
Cho S, Zanati S, Yong E，et al.Endoscopic cryotherapy for the management of gastric antral vascular ectasia[J]．Gastrointest Endosc，2008，68(5): 895-902.
[47]
Mathou NG, Lovat LB, Thorpe SM，et al.Nd：YAG laser induces long-term remission in transfusion-dependent patients with watermelon stomach[J]. Laser Med Sci，2004，18(4):213-218.
[48]
Selinger RR, McDonald GB, Hockenbery DM，et al.Efficacy of neodymium：YAG laser therapy for gastric antral vascular ectasia (GAVE) following hematopoietic cell transplant[J]．Bone Marrow Transpl，2006, 37(2):191-197.
[49]
Geller A, Gostout CJ, Balm RK.Development of hyperplastic polyps following laser therapy for watermelon stomach[J]．Gastrointest Endosc, 1996，43(1):54-56.
[50]
Bernstein CN, Pettigrew N, Wang KK，et al.Multifocal gastric neoplasia after recurrent laser therapy for the watermelon stomach[J]．Can J Gastroenterol，1997，11(5):403-406.
[51]
Patwardhan VR, Cardenas A．Review article：the management of portal hypertensive gastropathy and gastric antral vascular ectasia in cirrhosis[J]. Aliment Pharmacol Ther，2014，40(4):354-362.
[52]
Brijbassie A, Osaimi AA, Powell SM.Hormonal Effects on Nodular GAVE [J]．Gastroenterol Res，2013，6(2):77-80.
[53]
Nardone G, Rocco A, Balzano T，et al.The efficacy of octreotide therapy in chronic bleeding due to vascular abnormalities of the gastrointestinal tract [J]．Aliment Pharmacol Ther，1999，13(11): 1429-1436.
[54]
Iannone A, Principi M, Barone M，et al.Gastrointestinal bleeding from vascular malformations：Is octreotide effective to rescue difficult-to-treat patients？[J]．Clin Res Hepatol Gastroenterol，2016, 40(4):373-377.
[55]
Swanson E, Mahgoub A, MacDonald R，et al.Medical and endoscopic therapies for angiodysplasia and gastric antral vascular ectasia：a systematic review[J]．Clin Gastroenterol Hepatol，2014, 12(4):571-582.
[56]
Hung EW, Mayes MD, Sharif R，et al.Gastric antral vascular ectasia and its clinical correlates in patients with early diffuse systemic sclerosis in the SCOT trial[J]．J Rheumatol，2013，40(4):455-460.
[57]
Marie I, Ducrotte P, Antonietti M，et al.Watermelon stomach in systemic sclerosis: its incidence and management[J]．Aliment Pharmacol Ther, 2008, 28(4):412-421.
[58]
Schulz SW, O′Brien M, Maqsood M，et al.Improvement of severe systemic sclerosis-associated gastric antral vascular ectasia following immunosuppressive treatment with intravenous cyclophosphamide[J]．J Rheumatol，2009，36(8):1653-1656.
[59]
Lorenzi AR, Johnson AH, Davies G，et al.Gastric antral vascular ectasia in systemic sclerosis：complete resolution with methylprednisolone and cyclophosphamide[J]．Ann Rheum Dis, 2001，60(8):796-798.
[60]
Matsumoto Y, Hayashi H, Tahara K，et al.Intravenous Cyclophosphamide for Gastric Antral Vascular Ectasia Associated with Systemic Sclerosis Refractory to Endoscopic Treatment：A Case Report and Review of the Pertinent Literature[J]．Intern Med, 2019，58(1):135-139.
[61]
Papachristos DA, Nikpour M, Hair C，et al.Intravenous cyclophosphamide as a therapeutic option for severe refractory gastric antral vascular ectasia in systemic sclerosis[J]．Intern Med J, 2015，45(10):1077-1081.
[62]
Ge ZZ, Chen HM, Gao YJ，et al.Efficacy of thalidomide for refractory gastrointestinal bleeding from vascular malformation[J]. Gastroenterology, 2011，141(5):1629-1637,e1-4.
[63]
Bayudan AM, Chen CH.Thalidomide for refractory gastrointestinal bleeding from vascular malformations in patients with significant comorbidities[J]．World J Clin Cases，2020，8(15):3218-3229.
[64]
Bauditz J, Lochs H．Angiogenesis and vascular malformations: antiangiogenic drugs for treatment of gastrointestinal bleeding[J]. World J Gastroenterol，2007，13(45):5979-5984.
[65]
Albitar HAH, Almodallal Y, Papadakis KA，et al.Intravenous Bevacizumab Reduces Transfusion Requirements and Endoscopic Interventions in Patients With Gastric Antral Vascular Ectasia and Small Bowel Angioectasia[J]．Gastroenterology，2020，158(4): 1162-1163,e4.
[66]
Bhowmick BK.Watermelon stomach treated with oral corticosteroid[J]．J R Soc Med，1993，86(1):52.
[67]
Suzuki T, Hirano M, Oka H．Long-term corticosteroid therapy for gastric antral vascular ectasia[J]．Am J Gastroenterol，1996，91(9): 1873-1874.
[68]
Chien CC, Fang JT, Huang CC.Watermelon stomach an unusual cause of recurrent upper gastrointestinal bleeding in a uremic patient receiving estrogen-progesterone therapy：case report[J]. Changgeng Yi Xue Za Zhi, 1998，21(4):458-462.
[69]
Junquera F, Feu F, Papo M，et al.A multicenter, randomized, clinical trial of hormonal therapy in the prevention of rebleeding from gastrointestinal angiodysplasia[J]．Gastroenterology，2001，121(5): 1073-1079.
[70]
Khan S, Vaishnavi A．Pharmacotherapy for gastric antral vascular ectasia: dramatic response to tranexamic acid[J]．Gastrointest Endosc，2009, 70(1): 191; author reply-2.
[71]
McCormick PA, Ooi H, Crosbie O．Tranexamic acid for severe bleeding gastric antral vascular ectasia in cirrhosis[J]．Gut，1998, 42(5):750-752.
[72]
Jin T, Fei BY, Zheng WH，et al.Successful treatment of refractory gastric antral vascular ectasia by distal gastrectomy：a case report[J]．World J Gastroenterol，2014，20(38):14073-14075.
[73]
Naidu H, Huang Q, Mashimo H．Gastric antral vascular ectasia: the evolution of therapeutic modalities[J]．Endosc Int Open，2014，2(2):E67-73.
[74]
Clarke DL, McKune A, Thomson SR.Octreotide lowers gastric mucosal blood flow in normal and portal hypertensive stomachs[J]．Sur Endosc, 2003，17(10):1570-1572.
[75]
Nardone G, Compare D, Scarpignato C，et al.Long acting release-octreotide as "rescue" therapy to control angiodysplasia bleeding: A retrospective study of 98 cases[J]．Dig Liver Dis，2014, 46(8):688-694.
[76]
Peterson A, Varga J．Cyclophosphamide：a novel treatment of gastric antral vascular ectasia associated with systemic sclerosis？[J]．Curr Rheumatol Rep，2010，12(1):4-7.
[77]
Bruni C, Furst DE.The burning question：To use or not to use cyclophosphamide in systemic sclerosis[J]．Eur J Rheumatol，2020，7(Suppl 3):S237-241.
[78]
Panes J, Casadevall M, Fernandez M，et al.Gastric microcirculatory changes of portal-hypertensive rats can be attenuated by long-term estrogen-progestagen treatment[J]．Hepatology，1994，20(5):1261-1270.
[79]
Tran A, Villeneuve JP, Bilodeau M，et al.Treatment of chronic bleeding from gastric antral vascular ectasia (GAVE) with estrogen-progesterone in cirrhotic patients：an open pilot study[J]．Am J Gastroenterol，1999，94 (10): 2909-2911.
[80]
Moshkowitz M, Arber N, Amir N，et al.Success of estrogen-progesterone therapy in long-standing bleeding gastrointestinal angiodysplasia.Report of a case[J]．Dis Colon Rectum，1993，36(2): 194-196.
[81]
Moss SF, Ghosh P, Thomas DM，et al.Gastric antral vascular ectasia: maintenance treatment with oestrogen-progesterone[J]．Gut，1992，33(5): 715-717.
[82]
van Cutsem E, Rutgeerts P, Vantrappen G．Treatment of bleeding gastrointestinal vascular malformations with oestrogen-progesterone[J]. Lancet，1990，335(8695):953-955.
[83]
Marks R, Barlow JW, Funder JW.Steroid-induced vasoconstriction: glucocorticoid antagonist studies[J]．J Clin Endocrinol Metab，1982, 54(5): 1075-1077.
[84]
Folkman J, Ingber DE.Angiostatic steroids. Method of discovery and mechanism of action[J]．Ann Surg，1987，206(3):374-383.
[85]
Schacke H, Docke WD, Asadullah K．Mechanisms involved in the side effects of glucocorticoids[J]．Pharmacol Ther，2002，96(1):23-43.
[86]
Henry DA, O′Connell DL.Effects of fibrinolytic inhibitors on mortality from upper gastrointestinal haemorrhage[J]．BMJ，1989, 298(6681): 1142-1146.
[1] 史学兵, 谢迎东, 谢霓, 徐超丽, 杨斌, 孙帼. 声辐射力弹性成像对不可切除肝细胞癌门静脉癌栓患者放射治疗效果的评价[J/OL]. 中华医学超声杂志（电子版）, 2024, 21(08): 778-784.
[2] 齐伟亚, 方杰, 左志诚, 刘桂谦, 裴广楠, 刘波. 内窥镜辅助下改良Okutsu 法治疗腕管综合征的临床疗效[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(06): 503-506.
[3] 曹琮沅, 黄烁金, 何倩婷, 王安训. 平阳霉素复合剂治疗口腔颌面部脉管畸形的有效性和安全性[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(06): 368-374.
[4] 严华悦, 刘子祥, 周少波. 磷酸烯醇式丙酮酸羧激酶-1在恶性肿瘤中的研究进展[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 452-456.
[5] 高俊颖, 张海洲, 区泓乐, 孙强. FOLFOX-HAIC 为基础的肝细胞癌辅助转化治疗的应用进展[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 457-463.
[6] 李华志, 曹广, 刘殿刚, 张雅静. 不同入路下行肝切除术治疗原发性肝细胞癌的临床对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 52-55.
[7] 李博, 贾蓬勃, 李栋, 李小庆. ERCP与LCBDE治疗胆总管结石继发急性重症胆管炎的效果[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 60-63.
[8] 陈浩, 王萌. 胃印戒细胞癌的临床病理特征及治疗选择的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 108-111.
[9] 刘柏隆, 周祥福. 压力性尿失禁阶梯治疗的项目介绍[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 125-125.
[10] 刘柏隆. 女性压力性尿失禁阶梯治疗之手术治疗方案选择[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 126-126.
[11] 公宇, 廖媛, 尚梅. 肝细胞癌TACE术后复发影响因素及预测模型建立[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 818-824.
[12] 李一帆, 朱帝文, 任伟新, 鲍应军, 顾俊鹏, 张海潇, 曹耿飞, 阿斯哈尔·哈斯木, 纪卫政. 血GP73水平在原发性肝癌TACE疗效评价中的作用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 825-830.
[13] 魏志鸿, 刘建勇, 吴小雅, 杨芳, 吕立志, 江艺, 蔡秋程. 肝移植术后急性移植物抗宿主病的诊治（附四例报告）[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 846-851.
[14] 崔军威, 蔡华丽, 胡艺冰, 胡慧. 亚甲蓝联合金属定位夹及定位钩针标记在乳腺癌辅助化疗后评估腋窝转移淋巴结的临床应用价值探究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 625-632.
[15] 王誉英, 刘世伟, 王睿, 曾娅玲, 涂禧慧, 张蒲蓉. 老年乳腺癌新辅助治疗病理完全缓解的预测因素分析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 641-646.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号

AI
小
编
AI小编
你好！我是《中华医学电子期刊资源库》AI小编，有什么可以帮您的吗？