LDRf分型在食管联合胃底静脉曲张初次内镜治疗中的应用价值

Clinical value of LDRf typing for esophageal combined with gastric varices after therapeutic endoscopy

目的评价LDRf分型在食管联合胃底静脉曲张初次内镜治疗中的应用价值。方法回顾性总结2010年10月至2013年8月，336例采用LDRf分型，并按各型推荐治疗方法进行初次内镜治疗的食管联合胃底静脉曲张患者的临床资料，分析内镜治疗、并发症以及治疗后转归等情况。结果2例未治疗予内镜随访，其余334例顺利完成内镜治疗，无一例发生穿孔。术后1—10个月，再出血发生率为5．7％（19,（336）。随访6-12个月，食管静脉曲张消失累计164例（48．8％，164／336），胃底静脉曲张消失累计80例（23．8％，80／336），食管下段和贲门区静脉曲张均消失累计58例（17．3％，58／336），术后1年存活率达100％（336／336）。结论LDRf分型方法对食管联合胃底静脉曲张的内镜诊断及治疗具有较好指导意义，有助于提高内镜治疗疗效，并减少远期再发出血。

Objective To evaluate the clinical value of LDRf typing of the therapeutic endoscopy for esophageal combined with gastric varices. Methods According to classification criteria, treatments for e- sophageal gastric varices were recommended to 336 cases between October 2010 to August 2013. Endoscopic treatment, complications and treatment outcomes were retrospectively analysed. Results Two untreated ca- ses underwent the follow-up endoscopy; and endoscopic treatment was successfully completed in the remai- ning 334 cases, and no perforation occurred. In the follow-up of 1 to 10 months, rebleeding rate was 5.7% （19/336）. In the follow-up of 6 to 12 months, esophageal varices disappeared in 164 cases（48.8%, 164/ 336） ,gastric varices disappeared in 80 cases（23.8% ,80/336） ,and the lower esophageal and cardiac vari- ces disappeared in 58 cases（ 17. 3% ,58/336）. Survival rate after 1 year was 100% （336/336）. Conclusion LDRf typing has guiding significance for the diagnosis and treatment of esophageal combined with gastric varices, which helps to improve the efficacy of endoscopic therapy and reduce the rate of rebleeding.