超声内镜下对乙肝肝硬化伴食管-胃底静脉曲张患者弹簧圈置入术后评价
Evaluation of endoscopic ultrasonography in patients with hepatitis B cirrhosis and esophageal gastric varices after coil implantation
颜红霞 1肖景宝 1黄俊军 1孟娜2
作者信息
- 1. 湖北省洪湖市人民医院 消化内科 湖北 荆州 433200
- 2. 湖北省洪湖市人民医院 影像科 湖北 荆州 433200
- 折叠
摘要
目的 探讨超声内镜下对乙肝肝硬化伴食管-胃底静脉曲张患者弹簧圈置入术后治疗效果评估价值.方法 选取 150 例乙肝肝硬化伴食管-胃底静脉曲张患者,分为出血组 81 例和非出血组 69 例,均行超声内镜检查并接受弹簧圈置入术治疗.测量两组食管曲张静脉总横断面表面积、曲张静脉壁厚度、胃左静脉直径.评估治疗前后临近食管肌层的食管周围侧支静脉(Peri-ECV)、不与食管肌层相邻的食管旁侧支静脉(Para-ECV)、静脉曲张的最大直径、数量,连接它们的穿通支静脉,静脉曲张程度及Glasgow Blatchford 和 Child-Turcotte-Pugh评分.结果 出血组 81例患者中中度曲张患者 54 例,重度曲张患者 27 例.非出血组轻度曲张患者 69 例,出血组患者曲张静脉壁厚度、胃左静脉直径和总横断面表面积结果分别为(0.91±0.18)mm、(5.46±0.72)mm、(72.83±8.17)mm2,均高于非出血组,差异有统计学意义(P<0.05).治疗后患者Peri-ECV、Para-ECV、静脉曲张的最大直径、数量分别为(3.25±0.60)mm、(3.08±0.61)条和(4.49±0.66)mm、(3.12±0.74)条和(3.17±0.63)mm、(1.43±0.49)条及穿通支静脉,均低于治疗前,差异有统计学意义(P<0.05);治疗后患者静脉曲张程度显著降低,Glasgow Blatchford 和 Child-Turcotte-Pugh评分数值均低于治疗前,差异有统计学意义(P<0.05).结论 超声内镜能够准确显示食管胃底静脉曲张患者的血管及血流影像学表现,能有效对经弹簧圈治疗效果进行评估.
Abstract
Objective To evaluate the treatment efficacy of endoscopic ultrasonography in patients with hepatitis B cirrhosis and esophageal gastric varices treated with Coil implantation.Methods 150 patients with hepatitis B esophageal Gastric vari-ces were selected,including 81 patients with bleeding and 69 patients without bleeding.Those patients were examined by endo-scopic ultrasonography and treated with Coil implantation.the total cross-sectional area of esophageal varices,wall thickness of varices and diameter of left gastric vein were measured.And also,we evaluated evaluated the maximum diameter and number of the periesophageal collateral veins(Peri-ECV)adjacent to the esophageal musculature,the circumesophageal collateral veins(Para-ECV)not adjacent to the esophageal musculature,varicose veins,and the perforating branch veins connecting them before and after treatment.The degree of varicose veins and Glasgow Blatchford and Child-Turcotte-Pugh scores were assessed before and after treatment.Results There were 54 moderate cases and 27 severe cases in hemorrhage group.There were 69 patients with mild hemorrhage in non-hemorrhage group.The wall thickness of varicose vein,the diameter of left gastric vein and the to-tal cross-sectional area were(0.91±0.18)mm,(5.46±0.72)mm,(72.83±8.17)mm2 in the hemorrhage group,higher than those in the non-hemorrhage group(P<0.05).After treatment,the maximum diameter and number of Peri-ECV,Para-ECV and varicose veins were(3.25±0.60)mm,(3.08±0.61)and(4.49±0.66)mm,(3.12±0.74)and(3.17±0.63)mm,(1.43±0.49)and through the branch vein were lower than before treatment,the difference was statistically significant(P<0.05).The Glasgow Blatchford and Child-Turcotte-Pugh scores were(9.84±1.05)points and(8.73±1.01)points,lower than those before treatment(12.09±1.21)points and(11.28±1.15)points(P<0.01),and the degrees of varicose veins were significantly lower than those before treatment,the difference was significant(P<0.05).Conclusion Endoscopic ultrasonography can accurately show the Gastric varices vessels and blood flow in patients with esophageal varices,and is helpful in assessing the patient's con-dition,which can effectively evaluate the therapeutic effect of the coil.
关键词
超声内镜/弹簧圈置入术/乙肝肝硬化/食管-胃底静脉曲张Key words
Endoscopic ultrasonography/Coil implantation/Hepatitis B cirrhosis/Esophageal-Gastric varices引用本文复制引用
出版年
2024
NETL
NSTL
万方数据