超声内镜对肝硬化上消化道出血预测价值的探讨  

Evaluation of risk of upper gastrointestinal hemorrhage of cirrhosis based on endoscopic ultrasound

作　　者：韩继武[1] 庄丽维[1] 张亿倬[1] 薄挽澜[1] 

机构地区：[1]哈尔滨医科大学第一临床医学院消化内科,黑龙江哈尔滨150001

出　　处：《中国内镜杂志》2004年第8期8-9,12,共3页China Journal of Endoscopy

摘　　要：目的通过超声内镜检测肝硬化病人食管黏膜下曲张静脉总横断面表面积(CSA),探讨其与患者发生上消化道出血的关系,为临床预防上消化道出血的发生提供预防措施。方法应用高频率小探头高分辨超声内镜,对25例肝硬化伴门脉高压症病人进行全食管检测,然后分别测量食管各曲张静脉半径,并选取静脉曲张面积最大部位进行计算,记录各该部位总CSA值,探讨其与今后发生上消化道出血的关系。结果随访中出现上消化道出血的5例患者,其曲张静脉总CSA值为(0.86±0.52)cm2,与20例未出血者总CSA值(0.30±0.26)cm2相比,差异有显著性,P<0.05。结论应用高频率小探头高分辨超声内镜检测肝硬化患者总CSA值,可以检测出发生上消化道出血的高危病人。Objective:To study the relation between the risk of future upper gastrointestinal hemorrhage and the sum of the cross-sectional surface area(CSA)of the esophageal varices measured by endoscopic ultrasound.Methods:High-resolution endoluminal sonography,with high-frequency small ultrasound probes was used to measure the entire esophagus of25patients with portal hypertension of cirrhosis.The entire esophagus was imaged,and an image was selected at a opint where the varices appeared the largest,then the sum of CSA was measured.The follow-up time for each patient was observed to find out if there was a significant different between the sums of the CSA in the patients who bled compared with those who did not bleed.Results:5of25patients(20%)experienced esophageal variceal bleeding on the follow-up.The mean CSA±SEM of the sum of the esophageal varices in these patients was(0.30±0.52)cm 2 .20of25patients(75%)did not experienced variceal bleeding,the mean CSA±SEM of the sum of the esophageal varices in these patients was(0.86±0.52)cm 2 .The sum of the CSA between the patients who bleed and those who did not bleed was significantly different at the P<0.05level.Conclusions:To measure the sum of CSA of patients with cirrhosis can easily identify the patients who has the risk of future variceal bleeding.

关 键 词：超声内镜 肝硬化 上消化道出血 

分 类 号：R573.2[医药卫生—消化系统]