摘要
目的回顾性分析我院295例食管静脉曲张(EV)患者的病因和内镜下表现。方法 2014年1月~2016年6月新疆维吾尔自治区人民医院消化内镜中心诊断存在EV的住院患者295例,使用GE E9彩色多普勒超声、GE 64排螺旋CT和Olympus Gif-260型胃镜行相关检查。收集其临床资料,记录性别、年龄、病因和内镜下表现。结果在295例EV患者中,肝硬化258例(87.46%),其中主要有乙型肝炎肝硬化94例(31.86%),隐源性肝硬化58例(19.66%),丙型肝炎肝硬化37例(12.54%),原发性胆汁性肝硬化23例(7.80%)。非肝硬化相关病因37例(12.54%);内镜下食管静脉曲张轻度61例,中度68例,重度166例,重度EV常常合并红色征(89.8%),其合并胃静脉曲张及门脉高压性胃病明显增多,EV程度与胃静脉曲张、门脉高压性胃病和消化性溃疡显著相关(r=0.310、r=0.174、r=-0.173,P<0.05)。结论门静脉高压导致EV的主要病因仍是肝硬化,主要病因是乙型肝炎和隐源性肝硬化,但非肝硬化相关病因也占重要比重。随着EV程度的加重,胃静脉曲张和门脉高压性胃病的发病率升高,应注意区别防治。
Objective To investigate the etiology and endoscopic features of esophageal varices （EV）. Methods 295 patients with EV were hospitalized in Digestive Endoscopy Center,Xinjiang Autonomous Region People＇s Hospital between January 2014 and June 2016, and their clinical data and endoscopic manifestations were retrospectively analyzed. Results Among the 295 cases with EV,there were 258 cases （87.46%） resulting from liver cirrhosis,and the main etiologies were hepatitis B virus infection in 94 cases（31.86%）,cryptogenic liver cirrhosis in 58 cases （19.66%）,hepatitis C virus infection in 37 cases （12.54%）,primary biliary cirrhosis in 23 cases （7.80%）,and non-cirrhotic related etiologies in 37 cases （12.54%）;Under endoscope,mild esophageal varices were found in 61 cases,moderate in 68 cases and severe in 166 cases;Severe EV was often demonstrated by red sign （89.8%） and significantly increased the incidences of gastric varices and portal hypertensive gastropathy;The degree of esophageal varices was correlated to gastric varices,portal hypertensive gastropathy and peptic ulcer （r= 0.310,r=0.174 and r=-0.173,respectively,P〈0.05）. Conclusion The major cause of portal hypertensive esophageal varices is still liver cirrhosis,and the main etiologies are hepatitis B virus-related and cryptogenic liver cirrhosis. However,non-cirrhotic etiologies also account for an important proportion. With the aggravation of esophagus varices,the incidence of gastric varices and portal hypertensive gastropathy increase,and they must be taken into consideration in clinical practice.
出处
《实用肝脏病杂志》
CAS
2017年第5期550-553,共4页
Journal of Practical Hepatology
关键词
肝硬化
食管静脉曲张
病因
内镜表现
Liver cirrhosis
Esophageal varices
Etiology
Endoscopy
