1 078例食管胃静脉曲张内镜下表现特点

The endoscopic feature of varices in 1078 liver cirrhosis

摘要:

目的 对1 078例食管胃静脉曲张（GOV）患者的内镜下表现特点进行分析。 方法 随机抽取2011年11月～2012年6月解放军第302医院内窥镜中心诊断食管胃静脉曲张4 210例患者中1 078例常规检查患者进行分析。食管静脉曲张严重程度分为：轻度（EV1）、中度（EV2）和重度（EV3）。门脉高压性胃病（PHG）分为轻度和重度。对胃静脉曲张提出新的分型方法：GV1、GV2 、GV3、GV4和IGV。等级资料采用秩和检验。 结果 1 078例患者中，EV 333例（30.89%）；EV伴GV 728例（67.53%）：其中GV1占42.31%，GV2占14.42%，GV占19.78%，GV4占23.49%；IGV 17例（1.58%）。无PHG 542例（50.28%），轻度PHG 324例（30.06%），重度PHG 212例（19.66%）。PHG发生率与GOV的分型无明显关系（P >0.05）。PHG的发生率与EV的严重程度有关（P =0.0023）。 结论 GOV的内镜表现主要为EV伴GV占大多数，其中食管静脉曲张延伸至胃小弯最为常见，而食管静脉曲张只延伸至贲门也为数不少，可作为胃静脉曲张的分型之一。门脉高压性胃病的发生率随食管静脉曲张严重程度的增加而升高。

Abstract:

【Objective】 To investigate the endoscopic features of esophageal and gastric varices in 1078 liver cirrhosis patients. 【Methods】 The clinical data of 1078 patients with varices were analyzed who received endoscopy in our center from Nov 2011 to June 2012. The severity of esophageal varices were divided to EV1, EV2 and EV3. The portal hypertensive gastropathy were divided to mild and severe. The gastric varices were divided to GV1, GV2, GV3, GV4 and IGV with a new typing method. The ranked data was analyzed by rank sum test. 【Results】 In all patients, there were 17 IGV (19.66%), 333 EV (30.89%), 728 EV with GV (67.53%) and GV1 42.31%, GV2 14.42%, GV 19.78%, GV4 23.49% among them. 542 (50.28%) patients had no PHG, 324 (30.06%) patients and mild PHG, and 212 (19.66%) had severe PHG. The incidence of PHG related to the severity of EV (P =0.0023) but didn’t related to the type of varices (P >0.05). 【Conclusion】 Most varices in liver cirrhosis were EV with GV in our country and the most common type was GV1 among them. And the GV4 patients was considerable, too, which could be a new type. The incidence of PHG was increased with the severity of EV.