摘要
目的：探讨膈肌食管膜及裂孔功能状态与食管静脉曲张破裂出血间的关系。材料和方法：食管静脉曲张２２５例，食管静脉曲张破裂出血１２８例，出血率５６．９％，本文结合内镜，对食管静脉曲张程度分级；门静脉压力、内径测定及食管、胃气—钡双对比造影检查，统计深呼吸时膈肌食管膜及裂孔不同功能状态下曲张静脉管径变化幅度。结果：（１）门静脉内径≥１４．８±２．２ｍｍ与食管静脉曲张破裂出血并无显著对应关系，重度食管静脉曲张破裂出血发生率明显高于轻度、中度组，然而在出血组和非出血组间重度食管静脉曲张的发生率并无显著差异。（２）膈肌食管膜及裂孔松弛，食管静脉曲张破裂出血的发生率为７５．０％，深呼吸时曲张静脉直径变化幅度为３２．０％，膈肌食管膜及裂孔功能正常组分别为１９．６％，５６．０％。提示膈肌食管膜及裂孔松弛组曲张的食管静脉内处于持续淤血状态。（３）食管静脉曲张组的膈肌食管膜及裂孔松弛发生率明显高于健康对照组（Ｘ２＝１４．２４Ｐ＜０．００１）。结论：膈肌食管膜及裂孔松弛是诱发食管静脉曲张破裂出血的重要Ｘ线征象，也是预测曲张的食管静脉破裂出血的客观指标．
To investigate the relationship between the functional
status of diaphragmatic esophageal membrane,esophageal hiatus and variceal hemorrhage.
Material and Methods :225 Cirrhotics with esophageal varices,were studied with endoscopy,
portal venous pressure,portal vein calibre,and effect of respiration on the calibre of varices in
double contrast gastrography. ResuIts∶1)The internal diameter of portal vein≥14.8 ±
2.2mm was not significantly related to the hemorrhage and nonhemorrhage groups.Variceal
hemorrhage was more likely to occur in severe rather than in moderate and modest cases.The
frequency of severe varices was not statistically significant in hemorrhage and
nonhemorrhagic groups.(2)The frequency of variceal bleeding in patients with relaxed
phrenoesophageal membrane and diaphragmatic hiatus was 75.0%, and effect of deep
respiration on the amplitude of change of calibre of varices was 32.0%. This suggested the
presence of continuous blood stasis in the varices of the relaxed group.(3)Relaxation of
phrenoesophageal membrane and diaphragmatic hiatus were higher in patients with varices
than those of control which was statistically significant(X2=14.24 P< 0.001).Conclusion:The
relaxation of phrenoesophageal membrane and diaphragmaric hiatus are important factors in
inducing variceal rupture as well as an predictive indicator of variceal hemorrhage.
出处
《中华消化杂志》
CAS
CSCD
北大核心
1996年第5期257-260,共4页
Chinese Journal of Digestion
关键词
门静脉高压症
食管静脉曲张
膈肌
食管裂孔
Cirrhotics portal hypertensives Diaphragmatic-esophageal membrane Esophageal varices
Esophageal hiatus
