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目的:分析孤立性胃静脉曲张的临床和内镜形态特征。方法 :收集2007年1月至2015年5月期间我科经胃镜检查确诊为胃食管静脉曲张破裂出血的住院患者340例,其中孤立性胃静脉曲张38例(11.2%)。分析其病史资料、内镜所见、治疗情况及随访结果。结果:38例患者中常见病因分别为乙型肝炎后肝硬化(8例)、胰源性门静脉高压症(8例)及隐源性肝硬化(7例)。胃曲张静脉最常累及的区域分别为胃底大弯侧(84%)及胃底后壁侧(29%);形态上以多发结节状最常见(53%),其次为巨瘤状(37%);色泽上大多与周围正常黏膜相同(87%),且表面红色征少见(21%)。29例患者接受了内镜下硬化剂及组织黏合剂联合注射治疗术,所有患者对操作耐受良好,围手术期内未发生严重并发症。结论:孤立性胃静脉曲张为一少见疾病,其内镜形态复杂,缺乏明显色泽改变。胰源性门静脉高压症为其重要病因之一。内镜治疗可有效消退此类曲张静脉。
Objective: To analyze the clinical and endoscopic features of isolated gastric varices. Methods: A total of 340 hospitalized patients with gastroesophageal variceal bleeding diagnosed by gastroscopy from January 2007 to May 2015 were collected, including 38 cases of isolated varicose veins (11.2%). Analysis of its medical history, endoscopic findings, treatment and follow-up results. Results: The common causes in 38 patients were post-hepatitis B cirrhosis (8 cases), pancreatic portal hypertension (8 cases) and cryptogenic cirrhosis (7 cases). The regions most commonly involved in gastric varices were the greater curvature at the fundus (84%) and the posterior gastric wall (29%); the most common form was nodular (53%), followed by the giant tumors 37%). The color was mostly the same as the surrounding normal mucosa (87%), and the surface red signs were rare (21%). Twenty-nine patients underwent endoscopic sclerotherapy and tissue adhesive treatment. All patients were well tolerated and did not have any serious complications during the perioperative period. Conclusion: Solitary gastric varices is a rare disease with complex endoscopic morphology and lack of obvious color change. Pancreatic portal hypertension is one of the important causes. Endoscopic treatment can effectively dissipate such varicose veins.