门脉高压胃静脉曲张的内镜分类

Endoscopic Classification of Gastric Varices with Portal Hypertension

目的将234例门脉高压患者,根据内镜下静脉曲张的分布部位进行分类。方法内镜直视下对食管静脉曲张以及食管贲门静脉曲张(GOV1型)、食管胃底静脉曲张(GOV2型)、无食管静脉曲张的孤立性胃底静脉曲张(IGV1型)及异位静脉曲张(IGV2型)作内镜分类。结果234例门脉高压患者中,单纯食管静脉曲张67例(28.6%),食管静脉曲张伴贲门部静脉曲张98例(GOV1型,41.9%),食管静脉曲张经贲门延伸至胃底部46例(GOV2型,19.7%),内镜未见食管静脉曲张,仅有胃底静脉曲张者22例(IGV1型,9.4%),1例异位静脉曲张(IGV2型,0.4%)。结论门脉高压患者内镜检查表明半数以上患者存在胃静脉曲张,其中存在胃底静脉曲张的GOV2型和IGV1型68例,占全组患者的29.1%。应高度重视门脉高压患者胃静脉曲张的临床治疗,可选择内镜黏合剂、B-RTO术等方法。

Objective To ivestigate the classfication of gastric varices in 234 patients with portal hypertension by means of endoscopy. Methods All the patients were classfied into the following types ： simple esophageal varices （ GOV1 ）, esophagofundal varices （GOV2）, isolated gastric varices located in the fundus （IGV1）, isolated ectopic gastric varices （IGV2）. Results In these 234 patients simple esophageal varices were seen in 67 patients （28. 6% ）, GOV1 in 98 patients （41.9%）, GOV2 in 46 patients（19.7% ）,IGV1 in 22 patients （9.4%） and IGV2 in 1 patients（0.4% ）. Conclusion Gastric varices are observed in more than half of the patients with portal hypertension. More attention should be paid to the clinical treatment of gastric varices in patients with portal hypertension. And endoscopic scleotherapy with tissue adhesive, ballon-occluded retrograde transvenous obilteration（B-RTO） could be feasible methods.