摘要
近七年来经内镜检查有食管静脉曲张（ＥＶ）１６２例，全部为肝硬化并门静脉高压住院之病人。有ＥＶ出血（ＥＶＢ）史列为出血（ＶＢ组）１０２例，非出血组（ＮＢ）６０例，两组肝功能具有可比性。探讨内镜所见以红色征（＋＋～＋＋＋）和形态（Ｆ２或Ｆ３）之两征为主，同时与超声扫查（ＵＳ）和部分病例门静脉造影（ＰＧ）５０例测定门静脉系统血管径，以胃左静脉内径（ＬＧＶｄ）为主，进行两方对比，研究预测ＥＶＢ之意义。结果：内镜所见两征发生率，ＶＢ组明显高于ＮＢ组，差异非常显著（Ｐ＜０．００１）。ＵＳ和ＰＧ测ＬＧＶｄ平均值、ＶＢ组分别为５．３±１．８３ｍｍ（≥５ｍｍ占８８．２％）和８．１±２．３５ｍｍ（≥５ｍｍ占１００％）；ＮＢ组分别为３．９±１．１２ｍｍ（≥５ｍｍ占４０％）和５．１±１．２ｍｍ（≥５ｍｍ占４４％），前者较后者差异非常显著（Ｐ＜０．００５）。两组间测门静脉径、脾静脉径也有显著之差异，唯此两径与ＬＧＶｄ相比属正常值限者较多，似乎无助于预测ＥＶＢ。由于两种影象学所测三径（平均值和扩张率）呈等级正相关（ｒ＝０．７４～０．９４）故可用ＵＳ测ＬＧＶｄ代替ＰＧ，在ＮＢ组用ＵＳ测ＬＧＶｄ≥５ｍｍ之２４例，随访一年内首次发生ＥＶＢ有?
In order to predict esophageal variceal bleeding(EVB) in patients of liver cirrhosis with portal hrpertension,162 cases were divided into two groups. The variceal bleeding(VB) group in 102 cases and non-bleeding variceal(NB) group in 60 cases. Endoscpic finding of varices with red color sign(++～+++)and (F2 or F3)were recorded in all cases,simultaneous the diameter of the left gastric vein(DLGV) were measured by lntrasonography(US) in all cases and portovenography(PG) 50 Cases(both groups). The endoscopic finding of varices:81% cases with red color sign(++～+++)and 82.3% cases with form F2 or F3 could be found in the VB group, which were significantly higher than the ones in NB group(36% and 47.7% respectively)(P<0.005).The measured by US and PG were 5.3±1.83mm and 8. 1±2.35mm respectively in VB group,which were much higher than the ones in NB gruop(3.9±1.1mm and 5.1±1.2mm.respectively)(P<0.001).As to DLGV≥5mm(by US),24cass in NB group could be follow-up one year period,in whom the first EVB episode occured in 13 Cases(54.2%),while 3 cases without red color sign,so that US predicting corrective rate of EVB is 72.2%.The results showed that the measurment of DLGV>5mm by US(or PG) and endoscopic finding are useful parameters for predicting EVB.
出处
《胃肠病学和肝病学杂志》
CAS
1996年第3期217-222,共6页
Chinese Journal of Gastroenterology and Hepatology
