全国多中心食管胃静脉曲张出血调查  

A multi-center survey of esophagogastic variceal bleeding in China

作　　者：程留芳[1] 李长政[2] 

机构地区：[1]解放军总医院消化科,北京100853 [2]第二炮兵总医院消化科,北京100088

出　　处：《临床肝胆病杂志》2012年第6期462-464,共3页Journal of Clinical Hepatology

摘　　要：目的了解我国食管胃静脉曲张出血发病、治疗情况。方法建立食管胃静脉曲张出血互联网录入系统,由全国共29家医院对病例进行互联网上录入。共收集到有效病例1144例,病因中前两位分别为乙型肝炎肝硬化522例、酒精性肝硬化108例。治疗方法包括内镜下套扎术急诊87例、择期250例;内镜下硬化剂注射急诊198例、择期102例;外科治疗急诊18例、择期53例;胃冠状静脉栓塞77例;TIPS 12例;三腔两囊管100例;其余病例采用药物治疗。结果总急诊止血率88.2%。其中初始急诊治疗采用急诊套扎、急诊硬化剂注射、急诊外科治疗、急诊胃冠状静脉栓塞术、急诊TIPS、三腔两囊管压迫及药物治疗止血成功率分别为88.5%、90.9%、88.9%、87.0%、83.3%、78.0%、89.1%。有半年、1年、3年随访资料者分别为462例、334例、267例,死亡例数分别为38例、28例、127例,其中死于出血者分别为17例、13例、59例。结论食管胃静脉曲张出血在我国主要原因仍是乙型肝炎肝硬化;指南推荐的药物加内镜联合治疗在大约半数患者中能够实现;患者主要死因仍是出血。Objective To investigate the status of morbidity and therapy of esophagogastric varices in China.Methods A website for data-uploading was constructed and cases of esophagogastric varices were uploaded by 29 hospitals of China.Altogether 1144 cases were collected.The first and second causes were hepatitis B cirrhosis（522 cases） and alcoholic cirrhosis（108 cases） respectively.Treatment methods including endoscopic ligation（emergency 87 cases,optional 250 cases）,endoscopic sclerotherapy（emergency 198 cases,optional 102 cases）,surgery emergency 18 cases,optional 53 cases）,percutanious transhepatic venous embolization 77 cases,transjungular intrahepatic portal-systemic shunt 12 cases,balloon temponade 100 cases,and vasoactive agents for the other cases.Results The overall hemostasis rate was 88.2%.For emergence ligation,sclerotherapy,surgery,PTVE,TIPS,balloon temponade and medical therapy the hemostasis rate was 88.5%、90.9%、88.9%、87.0%、83.3%、78.0%、89.1% respectively Follow-up data were available for 462,334 and 267 cases at half year,1 year and 3 years respectively.Within them the death toll were 38,28 and 127 respectively and the number of cases died because of bleeding were 17,13 and 59 respectively.Conclusion The main cause of esophagogastric varices is still hepatitis B cirrhosis.About half the cases acquired combined therapy of vasoactive agents and endoscopic therapy recommended by the guidelines.The main cause of death is still bleeding.

关 键 词：食管和胃静脉曲张 流行病学方法 

分 类 号：R575.2[医药卫生—消化系统]