胃静脉曲张的内镜与临床特点

Gastric varices: endoscopic and clinical features

目的研究我国胃静脉曲张的内镜与临床特点。方法收集分析了1990至1997年我院胃镜检查发现胃静脉曲张 (GV )79人的相关资料。结果(1)GV检出率占食管静脉曲张 (EV )病人中的25.5 % ,GV并发出血低于EV者 (分别为20.3 %、32.4 % ,P<0.05) ;(2)GV分型 :胃食管静脉曲张I型 (GOV -I)者61例 (77.2 % ) ,GOV -II者14例 (17.7 % ) ,单纯胃静脉曲张I型 (IGV -I)者4例(5.1 % ) ,IGV -II型者无。(3)GV出血者中 ,GOV -I者6例 (37.5 % ) ,GOV -II者7例 (43.8 % ) ,IGV -I者3例 (18.7 % ) ,各型出血率分别为9.9 % (6/61)、50 % (7/14)及75 % (3/4)。结论我国GV的内镜与临床特点为GV检出率占EV病人中的25.5 % ,以GOV -I型最多见 ,其次为GOV -II型 ,不伴EV者也有但很少 ;GV出血率为20.3 % ,较EV出血少 ,其中以GOV -II型及IGV -I型出血多见。Sarin的GV分型法简易、能反映预后 ,可在我国推广应用。

Objective The endoscopic and clinical features of gastricvarices (GV) are reported. Methods The materials of endoscopically diagnosed GV in 79 patients between 1990 and 1997 were collected and reviewed. Results 25.5 percent of patients with esophageal varices (EV) was detected to have synchronus GV. Bleeding ensued in cases with GV (20.3%) being significantly lowered (P<0.05) than with EV. According to Sarin’s category of GV, GOV-I was found in 61 (77.3%) cases in this series, GOV-II in 14 (17.7%), and IGV-I in4 (5.1%). None had IGV-II grade. Bleeding arose from GOV-I in 6 instances(37.5%), from GOV-II in 7 (43.8%), and IGV-I in 3 (18.7%). The bleeding incidence being 9.9%(6/41), 50%(7/14), and 75%(3/4) respectively. Conclusion About 1/4 (25.5%) of GV occurred in association with EV in our hospital, with GOV-I and II as the dominant grade. Isolated GV appeared rarely. Nearly 1/5 (20.3%) of GV bled, less frequent than EV. Sarin’s category seemed quite simple and practicable in our hands.