摘要
目的与临床上有无出血可能性相结合 ,研究食管静脉曲张程度分级的可量化指标及可信限。方法回顾1993年1月至1998年12月经电子内镜诊断的食管静脉曲张485例患者 ,全部采用1991年日本门脉高压症研究会制定的记录标准进行记录 ,将此485例分为有出血组295例和无出血组190例 ,进行单因素分析及组合因素分析 ,两组比较以出血组病例占80 %以上为重度 ,两组所占百分率相近为中度 ,出血组病例占10 %以下为轻度。结果年龄、性别、颜色的因素意义不大 ,而形态 (F)、红色症 (Rc)与有无出血关系相当密切 ,若组合此两种因素 ,将Rc(+ ) +F3、Rc(+ ) +F2、Rc(-) +F3 定为重度 ,则出血组与未出血组分别占81.2 %(250/308)、18.8 %(58/308)。将Rc(-) +F2 定为中度 ,则出血组与未出血组分别占48.2 % (40/83)、51.8 % (43/83)。将Rc(-) +F1 和Rc(+ ) +F1 定为轻度 ,则出血组与未出血组分别占5.3(% ) (5/94)、94.7 % (89/94)。两组按此分出轻、中、重度 ,则两组差异显著 (P<0.001),具可信性。结论食管静脉曲张的形态及红色征因与出血关系密切 ,因此 ,二者结合 ,可作为食管静脉曲张内镜分级的量化标准。
Objective Based on likelihood of hemorrhage the quantitative criteria and confidence zone in grading esophageal varices (EV) were studied . Methods We conducted a retrospective review of 485 patients with endoscopically diagnosed EV between January 1993 and December 1998. Referring to the criteria adopted by Japanese Association of Portal hypertension, this series was categorized into bleeding group (n=285) and non-bleeding group (n=190) and analysedwith single factor as well as relevant factors. Results As to bleeding, age, sex, and color of EV were of no significance , while the form (F) and red color (Rc) sign of EV related closely with it. By combining the latter two factors, if EV with Rc(+)+F3, Rc(+)+F2 or Rc(-)+F3 was regarded as the serious pattern , 81.2 (n=250/308) percent of patient in bleeding group and 18.8 (n=58/308) percent in non-bleeding group fell into this category. If EV with Rc(-)+F2 was assumed as the moderate, about half of the cases in both groups ( 48.2%, n=40/83; 51%, n=43/83 respectively ) belonged to it. If EV with Rc(+)+F1 was considered as the mild, only 5.3 (n=5/94) percent of patients in bleeding group had such EV. Whereas the majority , 94.7 (n=89/94) percent, of the non-bleeding group did likewise. With the criteriathere existed significant difference (P< 0.001) and high confidence between groups. Conclusion The form and red color sign of EV are intimately related with bleeding. They can be recommended as quantitative criteria for endoscopic grading of EV.
出处
《中华消化内镜杂志》
2000年第4期201-204,共4页
Chinese Journal of Digestive Endoscopy
