孤立性胃静脉曲张110例临床分析

Clinical Analysis of 110 Cases of Isolated Gastric Varices

背景:各种疾病引起的门静脉高压常可导致食管胃静脉曲张甚至破裂出血。胃静脉曲张的发生率较食管静脉曲张低,但一旦破裂其出血量大、死亡率高。目前临床上关于孤立性胃静脉曲张(IGV)的研究较少。目的:探讨门静脉高压引起的IGV内镜下形态分型和临床特征。方法:回顾性分析110例IGV患者的临床资料,分析内镜下形态分型与临床特征的关系。结果:110例IGV患者中,内镜下形态分型主要为结节隆起型69例(62.7%)、条索型15例(13.6%)、葡萄串型14例(12.7%)。首发症状以上消化道出血为主(71.8%)。83例(75.5%、)IGV的原发病为肝源性疾病,胰源性疾病20例(18.2%)。36例行门静脉CTA检查的患者中,19例(52.8%)示胃-肾分流。内镜下形态分型与IGV的原发病相关(P<0.0001),而与首发症状无关。结论:IGV内镜下形态分型有助于其病因诊断和治疗方法的选择。

Background： Portal hypertension caused by various diseases can lead to gastroesophageal varices and bleeding. Gastric varices is less prevalent than esophageal varices but once bleeding occurs, it is more severe and with high mortality：, Relatively few studies on isolated gastric varices （IGV） have been reported. Aims： To study the endoscopic classification and clinical characteristics of IGV caused by portal hypertension. Methods： A retrospective analysis of the clinical data in 110 patients with IGV was performed, and the relationship between endoscopic classification and clinical characteristics was analyzed. Results： Of the 110 IGV patients, endoscopic classification was predominantly shown： tuberous type 69 patients （62.7%）, trabecular type 15 patients （13.6%）, and grape cluster type 14 patients （12.7%）. Upper gastrointestinal hemorrhage was the main initial symptom （71.8%）. The primary disease of IGV was hepatic disease in 83 cases （75.5%） and pancreatic disease in 20 cases （18.2%）. Thirty-six patients had undergone CT portal angiography, among them 19 patients （52.8%） showed gastro-renal shunt. Endoscopic classification had correlation with primary disease of IGV （P〈0.0001）, but not with initial symptoms. Conclusions： Endoscopic classification of IGV may help clinical diagnosis and selection of therapy.