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目的 :本文试图用经内镜超声微探头 (Ultrasonic Microprobe UMP)探讨门脉高压时食管下段壁内外静脉的解剖形态变化及其之间的相互关系。方法 :我们对 2 1例经临床资料和腹部超声明确诊断有肝硬化门脉高压的患者 ,在常规内镜检查完毕后 ,用频率为 2 0 MHz,直径为 2 .2 mm的超声微探头经内镜活检孔插入至食管腔内 ,并采用水浸法于内镜直视下扫查食管下段 ,详细观察了食管粘膜下曲张静脉 ,食管旁静脉及两者之间的连接静脉—穿静脉的大小、形态、数目及曲张静脉壁厚度 ,分析各曲张静脉之间的相互关系。另外以 6例证实无门脉高压食管静脉曲张的其他患者作为对照组。结果 :超声微探头显示门脉高压时食管粘膜下曲张静脉 ,食管旁静脉均扩大曲张 ,部分可见两者之间的连接静脉 -穿静脉亦显示扩张。食管旁静脉曲张越重 ,食管粘膜下静脉曲张程度越重 ,两者之间存在显著相关性 (r=0 .6 2 6 ,P<0 .0 1)。重度食管粘膜下曲张静脉的穿静脉显示率明显高于轻中度 (重度为 87.5 % ,中度为 2 5 % ,1例轻度静脉曲张患者无穿静脉和旁静脉显示 )。食管曲张静脉直径和其壁厚度呈负相关 ,但无统计学显著性意义 (r=- 0 .40 4,P=0 .0 6 6 )。结论 :超声微探头能简便、安全、客观、精确地评价门脉高压时食管下段静脉曲张 ,揭示食管?
OBJECTIVE: To explore the anatomical changes of the internal and external veins of the lower esophageal wall and its correlation with portal hypertension by using Ultrasonic Microprobe UMP. Methods: Twenty-one patients with cirrhosis and portal hypertension who had been diagnosed with cirrhosis by clinical data and abdominal ultrasonography were examined by conventional ultrasonography with a frequency of 20 MHz and a diameter of 2.2 mm after conventional endoscopy Endoscopic biopsy was inserted into the esophageal cavity, and the lower esophagus was scanned under endoscopy with water immersion method. The esophageal submucosal varicose veins, paraesophageal vein and the connection vein between the two The size, shape, number and varicose vein wall thickness, analyze the relationship between the varicose veins. In addition, 6 cases of other patients with portal hypertension without esophageal varices were selected as the control group. Results: Ultrasound microprobe showed that the esophageal submucosal varicose veins and esophageal paraventricular veins were all enlarged by portal hypertension, and some of the connected veins - veins also showed dilatation. The more esophageal varices and the more esophageal submucosal varices, there was a significant correlation between the two (r = 0.666, P <0.01). Severe esophageal submucosal varicose vein perforating veins showed significantly higher than mild to moderate (severe 87.5%, moderate 25%, 1 cases of patients with mild varicose veins and paraventricular vein showed). The diameter of esophageal varices was negatively correlated with the wall thickness, but there was no significant difference (r = - 0.404, P = .066). Conclusion: Ultrasound microprobe can be simple, safe, objective and accurate evaluation of portal hypertension when lower varicose veins, revealing the esophagus?