食管静脉曲张内镜治疗对门脉高压性胃病的影响

The effects of endoscopic treatment of esophagueal variceal on portal hypertensive gastropathy

目的 探讨食管曲张静脉内镜下治疗和门脉高压性胃病 (PHG)的关系。方法 对 47例食管曲张静脉采用内镜下治疗。其中内镜下食管曲张静脉套扎术 (EVL) 2 2例 ,内镜下硬化剂注射术 (EIS) 2 5例。所有患者在治疗前和食管静脉曲张消除后均行胃镜和多普勒超声检查。观察胃镜下PHG的胃粘膜变化和多普勒超声测量的门静脉宽度。结果 食管曲张静脉内镜下治疗后PHG的发生率为 19%,EVL组为 3 1.82 %,EIS组为 8%。内镜治疗前后门脉宽度变化 :EVL组治疗前为 15 .82± 4.76mm ,治疗后为 17.13± 4.95mm (P <0 .0 5 ) ;EIS组治疗前为 15 .3 3± 4.83mm ,治疗后为 15 .86± 4.62mm。结论 食管曲张静脉内镜治疗可能是PHG发生和加重的原因之一 ;EVL较EIV治疗更易诱发PHG。因此对已有PHG的食管静脉曲张患者内镜治疗时宜选择EIS。

Objective To investigate the relationship between the endoscopic treatment of esophgueal variceal and PHG.Methods 47 patients with esophgueal variceal were treated by using endoscopy (EVL:22 cases; EIS:25 cases). All patients were examined by gastroendoscopy and dopller ultrasonic before treating and after disappearing of esophagueal variceal. To observe the change of gastric mucous membrane under endoscopy and measure the width of portal vein under dopller ultrasonic.Results The occurrence rate of PHG was 19% after endocopic treatment of esophagueal variceal (EVL 31.82%, EIS 8%). The change of width of portal vein before and after treatment:before EVL:15.82±4.76 mm,after treatment:17.13±4.95 mm, P <0.05; before EIS:15.33±4.83,after treatment:15.86±4.62 mm P >0.05.Conclusion It may be a cause of the PHG development that esophagueal variceal was treated by using endoscopy. Compared with EIS,EVL is easier to induce PHG.