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目的探讨胃静脉曲张的病因及临床特点。方法回顾性分析北京协和医院2000年1月至2005年4月胃静脉曲张患者的病因及并发出血的情况,胃静脉曲张出血与红色征、曲张静脉类型、程度的关系,以及各型曲张静脉发生门脉高压性胃病的情况。结果我院5年间共诊治胃静脉曲张407例,占同期全部食管、胃静脉曲张的47.1%。胃静脉曲张的病因中,肝硬化占74.4%。孤立性胃静脉曲张的病因中脾静脉阻塞占37.2%,肝硬化占33%。407例胃静脉曲张患者中出血121例(29.7%)。在1型和2型胃静脉曲张、1型孤立性胃静脉曲张患者中,出血组红色征的阳性率、静脉曲张的程度均显著高于未出血组(P<0.01)。门脉高压所致的304例胃静脉曲张患者中发生门脉高压性胃病60例(19.7%),与食管静脉曲张发生门脉高压性胃病(22.3%)无差异,但孤立性胃静脉曲张很少出现门脉高压性胃病(9.6%,P<0.05)。结论胃静脉曲张最常见的病因是各种原因引起的肝硬化,而孤立性胃静脉曲张最常见的病因是脾静脉阻塞。红色征、静脉曲张程度是胃静脉曲张出血的危险因素。胃静脉曲张对门脉高压性胃病无影响。
Objective To investigate the etiology and clinical features of gastric varices. Methods A retrospective analysis of Beijing Union Medical College Hospital from January 2000 to April 2005 the cause of patients with gastric varices and bleeding, gastric varices bleeding and red signs, varicose vein types, extent of the relationship, and various types of varicose veins occurred Portal hypertensive gastropathy situation. Results 407 cases of gastric varices were diagnosed and treated in our hospital in 5 years, accounting for 47.1% of all esophageal and gastric varices in the same period. The cause of gastric varices, cirrhosis accounted for 74.4%. Isolated gastric varices in the cause of splenic vein occlusion accounted for 37.2%, cirrhosis accounted for 33%. Bleeding in 407 patients with gastric varices in 121 cases (29.7%). In patients with type 1 and type 2 gastric varices and type 1 isolated gastric varices, the positive rate of red signs and varices in bleeding group were significantly higher than those without bleeding (P <0.01). There were 60 cases (19.7%) of portal hypertensive gastropathy occurred in 304 cases of gastric varices due to portal hypertension, which was not different from those of portal hypertensive gastropathy (22.3%) in esophageal varices. However, isolated gastric varices Less portal hypertensive gastropathy (9.6%, P <0.05). Conclusions The most common cause of gastric varices is cirrhosis of the liver due to various causes, while the most common cause of isolated varices is splenic vein occlusion. Red sign, varicose veins is a risk factor for gastric variceal bleeding. Gastric varices have no effect on portal hypertensive gastropathy.