摘要
目的依据曲张静脉LDRf分型理论，探讨离体猪食管曲张静脉压力和直径对完全套扎度的影响。方法选取实验用猪静脉血管制成离体猪不同静脉压力血管模型，按预设定压力分成3组（A组25～30cmH20，B组35～40cmH20，C组45～50cmH20，1cmH20=0．098kPa），再选取猪食管进一步制成离体猪食管静脉曲张模型，根据所测直径分成3组（D1组0．4～1．0cm，D：组〉1．0～1．5cm，D，组〉1．5～2．0cm），采用单因素和多因素分析方法统计压力和直径对完全套扎度的影响。结果按压力分组时，A组完全套扎18个（56．25％，18／32），B组完全套扎12个（37．50％，12／32），C组完全套扎11个（33．33％，11／33），各组完全套扎率差异无统计学意义（χ2=3．6126，P=0．0573），但P值接近0．05，预示曲张静脉压力是完全套扎度的干扰因素；按直径分组时，D，组完全套扎35个（94．59％，35／37），D2组完全套扎6个（16．67％，6／36），D3组无一个完全套扎，各组完全套扎率差异有统计学意义（χ2=38．0014，P=0．0000），提示曲张静脉直径对完全套扎度影响较大。多因素非条件Logistic回归分析结果显示，食管曲张静脉压力、曲张静脉直径是完全套扎度的独立危险因素（P=0．000）。结论猪食管静脉曲张血管直径在0．4—1．0cm或血管压力在25—30cmH：0时完全套扎率高，套扎效果确实、完全，使用静脉曲张LDRf分型指导内镜下套扎猪食管静脉曲张是科学和可行的。
Objective To explore the influence of different pressures and diameters in vitro on com- plete ligation degree of esophageal varices based on the principle of LDRf typing. Methods According to the different preset venous pressure, the experimental porcine veins were used to establish vascular pressure models and divided into three groups （group A 25-30 cmH20, group B 35-40 cmH20, group C 45-50 cmH2 O）. The porcine esophagus was selected to establish models of esophageal varices, and divided into three groups according to the diameter of esophageal varices （ group D10. 4-1.0 cm, group D2 1.0-1.5 cm, group D3 1.6-2.0 cm）. Influence of pressure and diameter on complete ligation degrees was evaluated by univari- ate and multivariate analysis. Results Group A completed 18 ligations （56. 25%, 18/32）, group B 12 ligations （37.50% ,12/32）, and group C 11 ligations （33.33% ,11/33）, which were not significantly dif- ferent by pressure （χ2 =3. 6126, P =0. 0573）. Group D1 completed 35 ligations （94.59% ,35/37）, group D2 6 ligations（ 16. 67% ,6/36）, and D3 completed no ligation （0%, 0/24）, which were significantly differ- ent by diameter （χ2 = 38. 0014, P =0. 0000）, indicating that the diameter of the varices exerted greater in- fluence on the ligation degree. The logistic regression analysis showed that variceal pressure and diameter were the independent factors for complete ligation degree （P = 0. 000）. Conclusion Complete ligation iseffective and safe when the variceal diameter is 0. 4-1.0 cm, or variceal pressure is 25-30 cm H20. Endo- scopic treatment for varices with the guide of LDRf typing is scientific and feasible.
出处
《中华消化内镜杂志》
2014年第2期93-96,共4页
Chinese Journal of Digestive Endoscopy
基金
中国博士后科学基金（2012T50868）
北京市委、市政府重点工作区县级应急项目启动基金（Z111107056811048）
关键词
血管压力
食管静脉曲张
动物套扎模型
Vascular pressure
Esophageal varices
Model of animal ligation
