超声内镜下肝硬化并发食管静脉曲张患者套扎术治疗的预后价值及影响因素  

Prognostic value and influencing factors of endoscopic ultrasonography in the treatment of cirrhosis complicated with esophageal varices

作　　者：李玮 周静 侯洪波 肖俊茹[1] 吴丹[1] 张薇 刘斌 LI Wei;ZHOU Jing;HOU Hong-bo(Department of Infectious Diseases,Tangshan Infectious Disease Hospital,Tangshan Hebei,063000,China;不详)

机构地区：[1]唐山市传染病医院感染科,河北唐山063000 [2]唐山市传染病医院肝病科 [3]华北理工大学附属医院消化内科

出　　处：《中西医结合肝病杂志》2021年第2期138-140,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：中国肝炎防治基金会资助项目(No.TQGB20170015),河北省医学科学研究重点课题计划项目(No.20170933),河北省科技厅资助项目(No.162777133)。

摘　　要：目的:探讨超声内镜指导下肝硬化并发食管静脉曲张患者套扎术(EVL)治疗的预后价值以及影响因素。方法:选取肝硬化并食管静脉曲张的患者152例,所有患者均行EVL治疗,每6个月复查胃镜和超声内镜并随访1年。依据术后1年复查结果分为病例组(食管静脉曲张复发组)70例和对照组(食管静脉曲张未复发组)82例。分析所有患者的一般临床资料以及超声内镜指标等。结果:术后随访1年,无死亡患者,出现食管静脉曲张破裂出血患者8例,出血率5.26%(8/152)。EVL前后食管黏膜下中/重度、食管周围与食管旁重度静脉曲张例数与治疗前相比较,差异无统计学意义(P>0.05)。EVL 1年后,病例组食管黏膜下中/重度静脉曲张、食管周围重度静脉曲张及食管旁重度静脉曲张比率均高于对照组(77.14%vs 36.59%、74.29%vs 31.71%、72.86%vs 40.24%),差异均有统计学意义(P<0.05)。病例组在总横断面表面积、食管周围静脉穿通支最大直径、奇静脉最大直径、穿通支阳性例数明显高于对照组,曲张静脉壁厚度明显低于对照组,差异均有统计学意义(P<0.05)。结论:超声内镜对EVL术后食管静脉曲张有一定的诊断价值;食管曲张静脉总横断面表面积、食管周围静脉穿通支最大直径、奇静脉最大直径是静脉曲张复发的危险因素,曲张静脉壁厚度是其保护因素。Objective:To investigate the prognostic value and influencing factors of endoscopic ultrasonography in the treatment of cirrhosis complicated with esophageal variceal ligation(EVL).Methods:152 patients with cirrhosis and esophageal varices were selected.All patients were treated with EVL.Gastroscopy and ultrasonography were reviewed every 6 months and followed up for 1 year.According to the results of reexamination,70 cases were divided into case group(recurrence of esophageal vein group)and 82 cases into control group(no recurrence of esophageal vein group).Analysis of general clinical data and endoscopic ultrasonography indicators in all patients.Results:During the follow-up period of 1 year after EVL operation,there were no deaths and 5 patients with esophageal varices bleeding.The bleeding rate was 5.26%(8/152).EVL before and after radical treatment,the number of cases of esophageal submucosal,periesophageal and paraesophageal varices was significantly higher than that before treatment(P>0.05).One year after EVL radical operation,the rate of esophageal,submucosal varices,periesophageal varices and paraesophageal varices in the case group was higher than that in the control group(77.14%vs 36.59%,74.29%vs 31.71%,72.86%vs 40.24%),the difference has statistical significance(P<0.05).The total cross-sectional area,the maximum diameter of perforating branches of peripheral esophageal veins,the maximum diameter of azygos veins and the number of positive perforating branches in the case group were significantly higher than those in the control group.Conclusion:Endoscopic ultrasonography is valuable in the diagnosis of esophageal varices after EVL.The total transverse surface area of esophageal varices,the maxi-mum diameter of perforating branches of peripheral esophageal veins,and the maximum diameter of azygos veins are the risk factors for the recurrence of varices,and the thickness of the wall of varices is the protective factor.It can predict the risk of recurrent bleeding and play an important role in clinical pr

关 键 词：肝硬化 超声内镜 食管静脉曲张套扎术 影响因素 预后 

分 类 号：R575.2[医药卫生—消化系统]