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本文365例肝硬化经纤维内镜及电子胃镜证明均不同程度的存在门静脉高压性胃炎或合并消化性溃疡。门静脉高压一经形成,胃壁血管的血流量剧增,可达78～100％,并引起微血管普遍扩张,继发胃粘膜高动力循环,致动静脉短路入胃壁微循环,使胃粘膜血流量减少,局部缺氧。氢离子氯离子的逆向扩散,潴留在胃粘膜损害的最根本原因。门静脉高压性胃粘膜病变主要是胃粘膜 充血、水肿、糜烂、急性小溃疡或弥漫性点状出血,出血量可很大,仅次于食管曲张静脉破裂出血。但在肝功能不良时,门静脉高压性胃粘膜病变的出血比食管曲张静脉破裂出血几乎高出一倍。如广泛开展急诊内窥镜检查,可得出及时正确的诊断,从而达到合理全面的治疗。
This article 365 cases of liver cirrhosis by fiber endoscopy and electronic endoscopy showed varying degrees of presence of portal hypertension gastritis or peptic ulcer. Once the formation of portal hypertension, the blood flow in the stomach wall blood vessels increased dramatically, up to 78 ~ 100%, and lead to the general expansion of capillaries, secondary gastric mucosal hyperdynamic circulation, arterial short circuit into the gastric wall microcirculation, gastric mucosal blood flow decreased, Local hypoxia. Hydrogen ions reverse the proliferation of chloride ions, retention in the most fundamental cause of gastric mucosal damage. Portal hypertensive gastric mucosal lesions are mainly gastric mucosal congestion, edema, erosion, acute ulceration or diffuse punctate bleeding, bleeding can be large, second only to esophageal variceal bleeding. However, in patients with liver dysfunction, bleeding in patients with portal hypertensive gastric mucosal lesions is nearly twice as high as bleeding with esophageal variceal bleeding. Such as the extensive emergency endoscopy, can be obtained timely and correct diagnosis, so as to achieve a reasonable and comprehensive treatment.