摘要
目的观察1型孤立性胃静脉曲张(IGV-1)门静脉高压患者内镜下曲张静脉形态,探讨IGV-1型门静脉高压的病因、治疗和预后。方法回顾性分析2006年1月至2018年6月在上海交通大学医学院附属瑞金医院和瑞金医院北院就诊的54例IGV-1型门静脉高压患者的临床资料。依据内镜下曲张静脉形态进行分型,同时分析患者发病原因、治疗方式、疗效评估和预后。采用描述性方法进行统计学分析。结果54例IGV-1型门静脉高压患者中,内镜下形态为结节隆起型24例(44.4%),葡萄串型9例(16.7%),条索型5例(9.3%),树枝型3例(5.6%),混合型13例(24.1%)。病因分析发现,原发病为肝源性34例(63.0%),胰源性11例(20.4%),其他9例(16.7%)。采用黏合剂治疗3例(5.6%),硬化剂治疗2例(3.7%),黏合剂联合硬化剂治疗49例(90.7%)。疗效评估显示显效46例(85.2%)、有效8例(14.8%)、无效0例,改善率为100.0%(54/54)。预后分析发现,5年未出血35例(64.8%),10年未出血8例(14.8%);死亡9例(16.7%),其中胰腺癌6例,肝功能衰竭2例,消化道出血1例。结论IGV-1型门静脉高压内镜下形态以结节隆起型为主,病因主要为肝源性,黏合剂联合硬化剂治疗有利于胃曲张静脉的消退。
Objective To observe the endoscopic morphology of gastric varices of patients with portal hypertension type one isolated gastric varices(IGV-1)and to explore the etiology,treatment and prognosis of portal hypertension IGV-1.Methods From January 2006 to June 2018,at Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and North Branch of Ruijin Hospital,54 patients with portal hypertension IGV-1 were retrospectively analyzed.The varices were classified according to the endoscopic morphology and the etiology treatment,therapeutic efficacy and prognosis were also analyzed.Descriptive method was used for statistical analysis.Results Among the 54 patients with portal hypertension IGV-1,the endoscopic morphology of varices were tuber type in 24 patients(44.4%),grape string type in nine patients(16.7%),strip type in five patients(9.3%),dendritic type in three patients(5.6%)and mixed type in 13 patients(24.1%).Etiological analysis showed that the primary disease of 34 cases(63.0%)were hepatogenic,11 cases(20.4%)were pancreatic origin,and nine cases(16.7%)were from other diseases.As to treatment,three cases(5.6%)were treated with adhesive,two cases(3.7%)were treated with sclerotherapy,and 49 cases(90.7%)were treated with combination of adhesive and sclerotherapy.Therapeutic efficacy evaluation showed that 46 cases(85.2%)were significantly effective,eight cases were effective,0 case was ineffective,and all the 54 cases(100.0%)were improved.The prognostic analysis showed that 35 cases(64.8%)had no bleeding in five years and eight cases(14.8%)had no bleeding in 10 years.Nine patients(16.7%)died,including six cases of pancreatic cancer,two cases of liver failure and one case of gastrointestinal bleeding.Conclusions The endoscopic morphology of IGV-1 portal hypertension in mainly tuber type.The main cause is hepatogenic and the combination of adhesive and sclerotherapy is beneficial to the regression of gastric varices.
作者
杨翠萍
陈平
张梦茵
蔡波尔
吴云林
Yang Cuiping;Chen Ping;Zhang Mengyin;Cai Boer;Wu Yunlin(Department of Gastroenterology,North Branch of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 201801,China)
出处
《中华消化杂志》
CAS
CSCD
北大核心
2019年第12期824-827,共4页
Chinese Journal of Digestion
基金
上海市嘉定区卫生和计划生育委员会科研项目(2018-KY-01)。
关键词
高血压
门静脉
1型孤立性胃静脉曲张
分型
内镜下治疗
Hypertension
portal
Type one isolated gastric varices
Classification
Endoscopic therapy
