肝硬变患者食管的运动功能

Gastroesophageal motility in patients with liver cirrhosis

目的研究肝硬变患者食管胃运动功能的改变及其与上消化道出血的关系。方法采用单光子发射型机算机断层显像法对40例肝硬变患者和18例正常人的胃食管反流(GER)和胃液体排空(GE)时进行了检查。结果①肝硬变GER阳性率(42.5%)明显高于正常组(11.1%,P<0.05)。②肝硬变胃液体半排空时(GET_(1/2))平均值(33.70±5.57 min)极明显高于正常组(19.25±7.06 min,P<0.01);肝硬变胃液体排空迟缓发生率为60%,正常组为20%(P<0.05)。③肝硬变GER^+组上消化道出血和腹水的发生率分别为88.2%和94.1%,GER^-组为47.8%和60.9%(P<0.05)。随访1年,GER^+组平均出血次数(1.78±1.12)高于GER^-组(0.94±0.8,P<0.05)。结论肝硬变患者GER发生率增高,胃排空迟缓,且GER^+与上消化道出血关系密切。

AIMS To evaluate the gastroesophageal motility function in patients with liver cirrhosis and analysis the relationship between these functional changes and upper gastrointestinal hemorrhage. METHODS The gastroesophageal reflux (GER) and liquid gastric emptying(GE) were examined in 40 patients with liver cirrhosis and 18 normal controls by using single photon emission computed tomography(SPECT). RESULTS ① The positive rate of GER in liver cirrhosis (42.5%) was significantly higher than that in normal group (11.1%, P<0.05). ②The liquid gastric emptying in patients with liver cirrhosis was much slower than that in normal subjects(P<0.01 ). ③ The morbidities of upper gastrointestinal hemorrhage and ascites in GER^+ group of liver cirrhosis were 88.2% and 94.1%, which in GER^- group of liver cirrhosis were47.8% and 60.9%(P<0.05). Followed up for one year, the average frequences of rebleeding in GER^+ group (1.78±1.12) was significantly increased than that in GER^- group(0.94±0.8, P<0.05). CONCLUSIONS GER^+ is increased and gastric emptying delayed in patients with liver cirrhosis and there is a relation between GER^+ and hemorrhage in these patients.