内镜下聚桂醇治疗食管静脉曲张对门脉高压性胃病的影响

The influence of endoscopic injection of lauromacrogol on portal hypertension gastropathy in patients with esophageal varices

[目的]探讨内镜下聚桂醇治疗食管静脉曲张对门脉高压性胃病(PHG)的影响。[方法]对连续100例门脉高压食管静脉曲张出血后接受内镜下硬化剂聚桂醇治疗的患者开展临床随访研究,评估聚桂醇治疗后对PHG的影响。[结果]注射聚桂醇前33例患者存有PHG(33%);初次注射聚桂醇治疗后PHG患者为74例,其中新增轻度PHG患者41例;2次及以上注射聚桂醇治疗后PHG患者达88例,经注射聚桂醇后PHG发生率明显增高(P<0.01)。注射聚桂醇的次数与PHG的发生相关(P<0.01)。[结论]内镜下硬化剂聚桂醇治疗术(EIS)治疗食管静脉曲张,在控制出血和消退曲张静脉的同时,具有产生和加重PHG的可能,但大多为轻度PHG。患者经硬化剂治疗后控制出血,全身状况好转后应择期手术治疗或长期应用降门脉压药物,控制和改善PHG,预防食管静脉曲张和PHG出血。

[Objective]To investigate the influence of endoscopic sclerotherapy with lauromacrogol on portal hypertension gastropathy（PHG）in patients with esophageal varices. [Methods]One hundred patients with esophageal varices caused by portal hypertension who underwent endoscopic sclerotherapy with lauromacrogol were collected.The statuses of PHG before and after the sclerotherapy were analyzed. [Results]There were 33 patients（33%）who had PHG before taking sclerotherapy.After the first injection,the number of patients with PHG increased to 74（74%）,then raised to 88（88%） after two or more injections.The incidence of PHG was significantly increased after endoscopic sclerotherapy（P0.01）,which was related to the frequency of therapy taken（P0.01）. [Conclusion]Endoscopic injection sclerotherapy was likely to induce and aggravate the PHG while controlling variceal hemorrhage and obliterating varices,but most cases were mild.The patients should go for surgery when variceal hemorrhage is under control,or take long-term medication to lower the pressure of portal system,in order to improve the PHG and prevent bleeding.