食管曲张静脉内镜套扎术对门静脉高压性胃病的影响

Effect of esophageal variceal ligation on portal hypertensive gastropathy

目的探讨食管曲张静脉内镜套扎术(esophageal variceal ligation, EVL)对门静脉高压性胃病(portal hypertensive gastropathy, PHG)的影响. 方法对37例PHG在EVL治疗前后进行胃镜观察. 结果 PHG严重程度与肝功能状态有关,PHG发生率Child C级(100%,9/9)高于A级(60%,12/20)与B级(80%,16/20)(χ2=18.452,P=0.001).EVL治疗可以使PHG加重,但统计学无显著性差异(χ2=3.512,P＝0.173).6～12个月复查胃镜,无食管曲张静脉复发及破裂出血,无胃黏膜出血. 结论肝功能越差,PHG发生率越高.EVL治疗对PHG的影响呈动态性变化,EVL治疗后PHG有加重趋势.

Objective To investigate the effect of esophageal variceal ligation (EVL) on portal hypertensive gastropathy (PHG). Methods Gastroscopic examinations were performed both before and after the EVL in 37 cases of PHG. Results The severity of PHG was correlated with the liver functions, and the morbidity of PHG was higher in cases of Child C (100%, 9/9) than in cases of Child A (60%, 12/20) or Child B (80%, 16/20) ( χ 2=18 452,P =0 001). PHG could be exasperated by the application of EVL, but no statistical significance was seen ( χ 2=3 512,P =0 173). On re-examination of gastroscopy 6~12 months later, no relapse or re-bleeding of esophageal varices or gastric mucosa hemorrhage occurred. Conclusions The worse the liver functions, the higher is the incidence of PHG. EVL treatment creates a tendency to aggravating PHG.