肝硬化食管静脉曲张的无创诊断  

Noninvasive diagnosis of esophageal varices in liver cirrhosis

作　　者：周胜云[1] 段志辉 ZHOU Shengyun;DUAN Zhihui(Center of Endoscopy,Xingtai People’s Hospital,Xingtai,Hebei 054000,China)

机构地区：[1]邢台市人民医院内镜中心,河北邢台054000

出　　处：《临床肝胆病杂志》2020年第8期1842-1846,共5页Journal of Clinical Hepatology

基　　金：河北省卫生健康委重点科技研究计划(20201589)。

摘　　要：食管静脉曲张(EV)是肝硬化患者最常见的并发症之一。随着内镜及其他止血技术的发展,食管静脉曲张破裂出血的6周病死率仍然高达16%~26%,因此早期诊断EV尤其是高出血风险EV至关重要。目前,内镜仍然是诊断EV的金标准,但是有创性、价格昂贵、患者不舒适感限制了其推广。近些年,无创诊断EV的方法应运而生,最常用的是BavenoⅥ标准及其扩展版。总结及评述了血清学、超声、CT、MRI、弹性成像、胶囊内镜、超细内镜等方法在无创诊断肝硬化EV中的进展,强调简易无创技术的研发,为早期诊断EV提供帮助。Esophageal varices(EV)are the most common complication in patients with liver cirrhosis.Although achievements have been made in the development of endoscopy and other hemostatic techniques,the 6-week mortality rate is still as high as 16%-26%in patients with esophageal variceal bleeding,and therefore,early diagnosis of EV,especially high-risk EV,is of great importance.At present,gastroscopy is the gold standard for the diagnosis of EV,but its clinical application is limited by invasiveness,high cost,and patient discomfort.In recent years,several noninvasive tests have been proposed for the diagnosis of EV,among which the original Baveno VI criteria and its expanded criteria are the most commonly used ones.This article summarizes and reviews the advances in serological marker,ultrasound,CT,MRI,elastography,capsule endoscopy,and ultrathin endoscopy in the noninvasive diagnosis of EV and emphasizes the development of simple noninvasive technology,so as to provide help for the early diagnosis of EV.

关 键 词：肝硬化 食管和胃静脉曲张 诊断 

分 类 号：R575.2[医药卫生—消化系统]