门脉高压患者内镜下胃静脉曲张分类及其发病分析

Prevalence and classification of gastric varices in cirrhosis patients with portal hypertension

目的 对肝硬化患者内镜下胃静脉曲张进行分类 ,并分析其出血的好发因素。方法 确诊肝硬化门静脉高压患者 13 9例 ,采用Soehendra和Sarin标准进行食管 胃静脉曲张分类 ,分析各类型的发生率、出血率、静脉曲张间的关系及出血与肝功能的关系。结果 胃静脉曲张的发生率为 3 5 % ,以GOV 1发生率最高 ,多见于重度食管静脉曲张患者 ;胃静脉曲张出血率为 12 % ,见于肝功能B级以上患者及GOV 2和IOV 1,显著低于食管静脉曲张出血率 ,食管静脉曲张出血见于中度以上静脉曲张、肝功能B级以上患者。结论 胃静脉曲张在中国人群中有较高的发病率 ,出血多发生于胃底部位的曲张静脉 ,与肝功能差有关 ;食管静脉曲张出血发生率高于胃静脉曲张 ,与曲张静脉和肝功不良严重程度有关。

Objective To analyze the classification,prevalence of esophageal-gastric varix in liver cirrhosis patients and the possible risk factor of variceal bleeding.Methods In 139 patients with liver cirrhosis,the classification of esophageal-gastric varices was performed by Soehendra and Sarin standard during endoscopy.The prevalence of bleeding and liver function was evaluated.Results The prevalence of gastric varices was 35%,which mainly contributed to GOV1. GOV1 was associated with severe esophageal varices.The bleeding rate of gastric varices was 12%,which was lower than that in esophageal varices.GOV2,IOV1 and severe impairment of liver function were associated with high risks of bleeding.Esophageal varices bleeding mainly occurred in the patients with severe varices and impairment of liver function.Conclusion Gastric varices have high prevalence in Chinese population.Bleeding of gastric varices is mainly associated with fundal varices and impaired liver function.The risk of bleeding in esophageal varices is consistent with the size of varices and impairment of liver function.