门脉高压性胃病患者内镜下诊治临床特征分析  

Clinical characteristics of endoscopic diagnosis and treatment of portal hypertensive gastropathy

作　　者：陈平[1] 张梦茵[1] 周郁芬[1] 忻笑容[1] 吴云林[1] CHEN Ping;ZHANG Mengyin;ZHOU Yufen;XIN Xiaorong;WU Yunlin(Department of Gastroenterology,Ruijin Hospital North,Shanghai Jiaotong University School of Medicine,Shanghai 201801,China)

机构地区：[1]上海交通大学医学院附属瑞金医院北部院区消化科,上海201801

出　　处：《胃肠病学和肝病学杂志》2024年第10期1303-1307,共5页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的分析门脉高压性胃病患者的临床症状、内镜下表现及其与食管静脉曲张内镜下治疗的关系,为疾病预防性诊治提供依据。方法对肝硬化食管静脉曲张患者进行胃镜检查,记录食管静脉曲张和门脉高压性胃病的程度,收集患者的性别、体质量、血生化指标、肝功能评分数据,行部分患者内镜下食管静脉曲张硬化剂或套扎治疗后随访,并对临床数据进行统计学分析。结果纳入肝硬化食管静脉曲张患者162例,检出门脉高压性胃病为53.7%,且血清白细胞、血红蛋白、血小板和血氨水平在门脉高压性胃病与不伴门脉高压性胃病组间差异有统计学意义(P<0.01)。在87例门脉高压性胃病患者中,严重程度组间比较肝功能评分差异有统计学意义(P<0.01)。门脉高压性胃病导致非食管胃静脉曲张破裂伴出血患者发生率为77.2%。内镜下治疗35例患者中,门脉高压性胃病中-重度占比由28.6%增至71.4%,与治疗前比较,差异有统计学意义(P<0.01)。结论肝硬化食管静脉曲张患者伴门脉高压性胃病发病率较高,已成为肝硬化患者主要的出血原因之一。重视食管静脉曲张内镜下治疗后对疾病的影响,将为门脉高压性胃病引起的消化道出血的诊治提供一定的依据。Objective To investigate the clinical and endoscopic characteristics of portal hypertension gastropathy and its relationship with endoscopic treatment of esophageal varices,to provide evidences for prevention and treatment of disease.Methods Patients with liver cirrhosis associated with esophageal varices were enrolled for gastroscopy examination,and the degree of esophageal varices and portal hypertension gastropathy with patients were recorded.The data of gender,body weight,serum biochemical index and liver function scoring were collected.The data of following-up with patients after endoscopic esophageal varices hardener or ligation were performed.These clinical data were statistically analyzed.Results A total of 162 cases of liver cirrhosis with esophageal varices patients were included,and the detection rate of portal hypertension gastropathy with patients was 53.7%,and there were statistically significant differences in the levels of serum white blood cells,hemoglobin,platelets and ammonia between portal hypertension gastropathy and without portal hypertension gastropathy in patients(P<0.01).There were significant differences in liver function scoring in different severities with portal hypertensive gastropathy in 87 patients(P<0.01).The incidence of non-esophageal and gastric varices hemorrhage caused by portal hypertensive gastropathy was 77.2%.After endoscopic treatment,the proportion of moderate and severe portal hypertensive gastropathy were increased from 28.6%to 71.4%,and the difference was statistically significant compared with before endoscopic treatment in 35 cases with esophageal varices patients(P<0.01).Conclusion The incidence of portal hypertensive gastropathy was high in patients with portal hypertension,which has become one of the main causes of hemorrhage in patients with liver cirrhosis.Paying attention to the influence of endoscopic treatment of esophageal varices in disease will provides the basis for the diagnosis and treatment of gastrointestinal hemorrhage associated with portal hyper

关 键 词：食管静脉曲张 门脉高压性胃病 出血 内镜下治疗 

分 类 号：R57[医药卫生—消化系统]