食管静脉曲张结扎术后门脉高压性胃病加重的相关因素分析  

Analysis of risk factors about portal hypertensive gastropathy after esophageal varices ligation

作　　者：杜爱民[1] 付青春[2] 张为强 

机构地区：[1]解放军第85医院消化内科,上海200052 [2]解放军第85医院肝病中心,上海200052 [3]上海市公共卫生中心医务科

出　　处：《胃肠病学和肝病学杂志》2011年第10期909-912,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的分析食管静脉曲张结扎术(EVL)后导致门脉高压性胃病(PHG)加重的各种相关危险因素。方法回顾性分析154例肝硬化患者施行EVL前后PHG的加重程度。结果 43例有门奇静脉断流术史伴H.pylori阳性者,EVL前后患者重度PHG的总构成比分别为51.16%和74.42%(P<0.05);按肝功能Child-Pugh(A+B)级、C级分组,各组患者EVL前后的重度PHG构成比分别为30.77%、38.46%(P>0.05)和60.00%、90.00%(P<0.05)。33例有门奇静脉断流术史H.pylori阴性者,EVL前后的重度PHG总构成比分别为21.21%和36.36%(P<0.05)。按肝功能Child-Pugh(A+B)级、C级分组,各组患者EVL前后的重度PHG总构成比为14.29%、21.43%(P>0.05)和26.32%、47.37%(P<0.05)。15例无门奇脉断流术史H.pylori阳性者,EVL前后的重度PHG的总构成比分别为20.00%和40.00%(P<0.05);按肝功能Child-Pugh(A+B)级、C级分组,各组患者EVL前后的重度PHG构成比分别为16.67%、16.67%(P<0.01)和22.22%(1/6)、55.56%(P<0.01)。46例无门奇脉断流术史H.pylori阴性者,EVL前后重度PHG的总构成比分别为17.39%和23.91%(P>0.05);按肝功能Child-Pugh(A+B)级和C级分组,各组患者EVL前后的重度PHG构成比分别为14.29%、19.05%(P>0.05)和20.00%、28.00%(P<0.05)。结论肝硬化患者EVL前后的重度PHG构成比率与肝功能Child-Pugh分级呈明显正相关;门奇静脉断流术、H.pylori感染均为肝硬化患者EVL后引起PHG程度加重的重要危险因素。Objective To analyze the various risk factors with aggravate portal hypertensive gastropathyc （PHG） after esophageal variceal ligation （EVL）. Methods A retrospective analysis of 154 cases with liver cirrhosis underwent the increased degree of PHG after EVL. Results Forty-three patients after portal azygous devascularization with H. pylori-positive, severe PHG total composition ratio were 51.16% and 74.42% before and after EVL （P 〈 0.05） ; by liver function Child-Pugh grade （ A ＋ B） and C groups, proportion ratios of each group patients with severe PHG were 30.77% , 38.46% （P 〉 0.05） and 60.00% , 90.00% before and after EVL （P 〈0.05）. Thirty-three patients with portal azygous devascularization history of H. pylori negative, the total composition ratios of severe PHG were 21.21% and 36.36% before and after EVL （P 〈0.05）. According to liver function by Child-Pugh （A ＋ B） grade, C grade group, total composition ratios of earch group patients with severe PHG were 14.29%, 21.43% （P 〉 0.05） and 26.32% , 47.37% before and after EVL （P 〈0.05）. Fifteen H. pylori postive patients without history of portal azygous devascularization, the total composition ratios of severe PHG were 20.00% and 40.00% before and after EVL （P 〈 0.05 ） ; by liver function Child-Pugh（A ＋ B） grade, C grade group, proportion ratios of each group patients with severe PHG were 16.67%, 16.67% （ P 〈 0.01 ） and 22.22% , 55.56% （P 〈 0.01 ） before and after EVL. Forty-six patients without portal azygous devascularization history of H. pylori negative, overall proportion ratios were 17.39% and 23.91% （P 〉 0.05） before and after EVL; by liver function Child-Pugh （ A ＋ B） and C-level group, the proportion ratios of each group patients with severe PHG were 14.29% , 19.05% （P 〉0.05） and 20.00%, 28.00% before and after EVL （P 〈 0.05）. Conclusion Composition ratio of cirrhotic patients with severe PHG after EVL and liver function in Child-Pugh classification is

关 键 词：肝硬化 静脉曲张结扎 幽门螺杆菌感染 门奇静脉断流术 门脉高压性胃病 

分 类 号：R573[医药卫生—消化系统]