肝癌患者门静脉高压性胃病的胃镜表现及相关影响因素分析  

Analysis of gastroscopic manifestations and related influencing factors of portal hypertensive gastropathy in patients with liver cancer

作　　者：骆成俊 李黎 韩建雄 朱晓娟 刘彦 LUO Cheng-jun;LI Li;HAN Jian-xiong;ZHU Xiao-juan;LIU Yan(Department of Gastroenterology,Chengdu Fifth People's Hospital,611130 Chengdu,China;Department of Radiology,Chengdu Fifth People's Hospital,611130 Chengdu,China)

机构地区：[1]成都市第5人民医院消化内科,四川成都611130 [2]成都市第5人民医院放射科,四川成都611130

出　　处：《临床消化病杂志》2022年第1期12-16,共5页Chinese Journal of Clinical Gastroenterology

基　　金：2018年四川省科技厅普及项目(No:2018 JY0276);2018年成都市科技局项目(No:2018-YF05-01228-SN);2017年四川省卫计委重点项目(No:17 ZD008)。

摘　　要：[目的]分析肝癌患者门静脉高压性胃病(portal hypertension gastopathy,PHG)的胃镜表现及相关影响因素。[方法]入选行胃镜检查的肝癌患者191例,观察其胃镜下表现及分析相关影响因素。[结果]191例肝癌患者,镜下表现为门静脉高压性胃病(PHG)137例(71.7%),其中轻症74例(54.0%),重症63例(46.0%);无PHG54例(28.3%)。PHG组患者消化道出血症状、食管胃静脉曲张、有食管胃静脉曲张术史、合并肝硬化、肝性脑病、自发性细菌性腹膜炎、中-大量腹水以及门静脉血栓形成的比例均高于无PHG组,PHG组患者肝功能Child-Pugh分级以B、C级为主,门静脉内径大于无PHG组,而血红蛋白、血小板、白蛋白低于非PHG组,ALT、AST、胆红素及PT则高于无PHG组(均P<0.05或0.01)。PHG严重程度随着食管胃静脉曲张和肝功能分级的增加而加重,消化道出血比例随之增加。[结论]肝癌患者易合并PHG引起消化道出血,食管胃静脉曲张程度和肝功能是主要影响因素,随着肝癌患者生存期延长,PHG应得到消化科足够重视。[Objective]]To analyze the gastroscopic manifestations and related influencing factors of portal hypertensive gastropathy(PHG)in patients with liver cancer.[Methods]Retrospectively study the 191 liver cancer patients underwent gastroscopy.The gastroscopy manifestations were counted and related influencing factors were analyzed.[Results]In 191 patients with liver cancer,137 cases(71.7%)showed PHG under macroscope,including 74 cases(54.0%)with mild disease,63 cases(46.0%)with severe disease,and 54 cases(28.3%)without PHG.The proportion of patients in the PHG group with gastrointestinal bleeding symptoms,esophageal gastric varices,history of esophageal gastric varices,combined with liver cirrhosis,hepatic encephalopathy,spontaneous bacterial peritonitis,moderate to large ascites,and portal vein thrombosis were higher than those without PHG.In the PHG group,the Child-Pugh classification of liver function of patients in the PHG group was mainly B and C.The portal vein diameter was larger than the PHG group,while hemoglobin,platelets,and albumin were lower than those in the non-PHG group,while ALT,AST,bilirubin and PT were higher compared with the non-PHG group(all P<0.05 or 0.01).The severity of PHG aggravated with the increase of esophageal gastric varices and liver function classification,and the proportion of gastrointestinal bleeding increased.[Conclusion]Patients with liver cancer are likely to be combined with PHG to cause gastrointestinal bleeding.The degree of esophageal gastric varices and liver function are the main influencing factors.With the prolonged survival of patients with liver cancer,PHG should be paid enough attention by the Gastroenterology Department.

关 键 词：肝癌 门静脉高压性胃病 胃镜 影响因素 

分 类 号：R735.7[医药卫生—肿瘤]