孤立性胃底静脉曲张的临床特点分析

Clinical characteristics of isolated gastric varices

目的分析孤立性胃底静脉曲张的临床特点。方法回顾性分析2014年1月至2016年7月经吉林大学第一医院内镜下检查发现孤立性胃底静脉曲张患者35例。结果病因:肝硬化门脉高压21例、胰源性门脉高压6例、其他8例。治疗方法:脾切断流术治疗8例,术后复发再出血死亡1例、经颈内静脉肝内门体分流术(TIPS)治疗2例、肝移植1例、占位手术切除2例、组织胶栓塞治疗4例、套扎治疗1例和内科保守治疗17例。结论引起孤立性胃底静脉曲张的主要病因是肝炎后肝硬化所致门脉高压。外科手术治疗效果最好,内镜下栓塞治疗短期效果较好,可重复性强,但复发率较高。

Objcetive To analyze the clinical characteristics of isolated gastric varices. Methods The clinical data of 35 patients diagnosed as isolated gastric varices in the First Hospital of Jilin University were analyzed retrospectively during January 2014 to July 2016. Results Etiology ： Posthepatitic cirrhosis and portal hypertention （ n = 18 ） , alcoholic cirrhosis and portal hypertention （ n = 3 ） , pancreatic portal hypertention （ n =6） and other etiologies（n = 3 ） . Treatment： Surgery was performed in 13 cases. 8 patients were treated with splenectomy and devascularization, 1 of whom died of rebleeding 8 months after operation.2 patients were treated with TIPS. 1 case had a liver transplant. 2 patients were treated with surgical removal of the occupancy lesions. 4 cases were injected with tissue glue. EVL was performed in 1 case. 17 patients accepted only medicine treatment. Conclusions The main etiology leading to isolated gastric varices is posthepatitic cirrhosis and portal hypertension. Surgery is the best choice for selective cases. Tissue glue is good for short-term clinical results,but with high recurrence rates.