超声内镜与多层螺旋CT血管造影对食管胃底静脉曲张的诊断价值研究  

Diagnostic value of endoscopic ultrasonography and multi-slice spiral CT angiography in esophageal and gastric varices

作　　者：苏淼[1] 杨艳双 田志颖[1] 王丽华[1] SU Miao;YANG Yan-shuang;TIAN Zhi-ying;WANG Li-hua(Department of Gastroenterology,Harrison International Peace Hospital,Hengshui People's Hospital,Hengshui 053000,China;2Archives Management Section of Harrison International Peace Hospital,Hengshui 053000,China)

机构地区：[1]哈励逊国际和平医院,衡水市人民医院消化内科,河北衡水053000 [2]哈励逊国际和平医院档案管理科,河北衡水053000

出　　处：《中国中西医结合消化杂志》2019年第6期431-435,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：河北省衡水市科技计划项目(No:2017014013C-16)

摘　　要：[目的]探讨超声内镜与多层螺旋CT血管造影对食管胃底静脉曲张的诊断价值,为临床上采取积极的预防及治疗措施提供参考。[方法]选取2016年1月~2018年10月于我院就诊的乙型肝炎病毒(HBV)感染患者192例,分为单纯HBV感染患者(CHB组)117例,HBV感染肝硬化患者(肝硬化组)75例。所有患者均行常规胃镜和超声内镜检查,肝硬化组患者均行多层螺旋CT血管造影检查,观察食管、胃底各部位曲张静脉情况及穿通支检出情况以及超声内镜与多层螺旋CT血管造影检出率情况。[结果]①肝硬化组食管黏膜下静脉曲张检出率为34.67%,高于CHB组的8.55%;肝硬化组胃底黏膜下静脉曲张检出率为38.67%,高于CHB组的11.97%,差异均有统计学意义(P<0.05)。②肝硬化组在食管周围静脉曲张、食管旁静脉曲张、胃底周围静脉曲张、胃底旁静脉曲张检出率和穿通支情况均高于CHB组(36.00%vs.8.55%、37.33%vs.14.53%、29.33%vs.8.55%、41.33%vs.15.38%、28.00%vs.7.69%),差异均有统计学意义(P<0.05)。③EUS和MSCTA在食管外周、胃底黏膜下、胃底外周静脉曲张比较,差异无统计学意义;EUS对食管黏膜下静脉曲张检出率为69.33%,高于MSCTA的49.33%,差异有统计学意义(P<0.05)。[结论]超声内镜能够早期发现食管胃底黏膜下和外周静脉曲张,有助于临床早期诊断和早期干预治疗;超声内镜对食管黏膜下静脉曲张检出率明显优于MSCTA检查,在胃底黏膜下、胃底外周以及食管外周静脉与MSCTA检出率具有高度一致性。[Objective]To explore the value of endoscopic ultrasonography and multi-slice spiral CT angiography in the diagnosis of esophageal and gastric varices.To provide reference for taking active preventive and therapeutic measures in clinic.[Methods]192 patients with HBV infection who visited Harrison International Peace Hospital from January 2016 to October 2018 were selected.They were divided into 117 patients with simple HBV infection(CHB group)and 75 patients with hepatocirrhosis(hepatocirrhosis group).All patients underwent routine gastroscopy and endoscopic ultrasonography,and patients with liver cirrhosis underwent multi-slice spiral CT angiography.To observe the varices of esophagus and fundus of stomach,the detection of perforating branches and the detection rate of endoscopic ultrasonography and multi-slice spiral CT angiography.[Results]①The detection rate of esophageal submucosal varices in cirrhosis group was 34.67%,higher than 8.55%in CHB group;the detection rate of gastric fundus submucosal varices in cirrhosis group was 38.67%,higher than 11.97%in CHB group,P<0.05,the difference was statistically significant.②The detection rate and perforating branches of periesophageal varices,paraesophageal varices,perigastric varices and paragastric varices in cirrhosis group were higher than those in CHB group(36.00%vs.8.55%,37.33%vs.14.53%,29.33%vs.8.55%,41.33%vs.15.38%,28.00%vs.7.69%).P<0.05,the difference was statistically significant.③There was no significant difference between EUS and MSCTA in esophageal,gastric submucosa and gastric fundus varices(P>0.05).The detection rate of EUS in esophageal submucosa varices was 69.33%,higher than that of MSCTA(49.33%,P<0.05).There was significant difference between EUS and MSCTA(P<0.05).[Conclusion]Endoscopic ultrasonography can detect esophageal and gastric fundus submucosa and peripheral varices early,which is helpful for early diagnosis and early intervention.The detection rate of endoscopic ultrasonography for esophageal submucosa varices is significantly bette

关 键 词：超声内镜 食管胃底静脉曲张 多层螺旋CT血管造影 诊断价值 

分 类 号：R571[医药卫生—消化系统]