论文部分内容阅读
目的 对肝炎肝硬化门静脉高压症病人胃粘膜的内镜表现进行分析研究 ,探讨以肝炎为病因的门静脉高压性胃病 (PHG)的内镜特征。方法 对 172例肝炎肝硬化门静脉高压症病人 (A组 )施行胃镜检查 ,详细记录镜下胃粘膜的病理表现及其分布 ,并与同期 114例尚未形成门静脉高压的肝炎肝硬化 (B组 )和 97例慢性胃炎 (C组 )进行对比。结果 A组主要的内镜表现包括马赛克征、糜烂、瘀点和樱桃红斑 ,检出率分别为 6 5 1%、5 0 0 %、4 5 3%和 19 8% ,均明显高于B、C两组 (P <0 0 1)。其中最基本的病变是马赛克征。樱桃红斑的检出率虽较低 ,但只在A组中见到。活动性出血的检出率A组亦高于B、C两组 (P <0 0 1)。B组与C组胃镜下的各种表现及其分布无显著性差异 (P >0 0 5 )。结论 马赛克征、糜烂和瘀点是肝炎肝硬化PHG的主要内镜表现 ,而樱桃红斑则是其特有的病变。肝炎肝硬化在形成门静脉高压以前 ,其胃粘膜的内镜表现与普通慢性胃炎相似。
Objective To analyze the endoscopic features of gastric mucosa in patients with liver cirrhosis and portal hypertension and to explore the endoscopic features of hepatic portal hypertensive gastropathy (PHG). Methods A total of 172 patients with portal hypertension of liver cirrhosis (group A) underwent gastroscopy. The histopathological features and distribution of gastric mucosa were recorded in detail. In the same period, 114 patients with cirrhosis (group B) who did not form portal hypertension and 97 cases of chronic gastritis (C group) for comparison. Results The main endoscopic findings in group A included mosaic signs, erosions, petechiae and cherry erythema. The detection rates were 65.1%, 540.0%, 45.3% and 19.8%, respectively, which were significantly higher than those of B, C two groups (P <0.01). The most basic of these is the mosaic syndrome. The detection rate of cherry erythema is low, but only seen in group A. The detection rate of active bleeding was also higher in group A than in groups B and C (P <0.01). The performance and distribution of gastroscopy in group B and group C were not significantly different (P> 0.05). Conclusions Mosaic signs, erosion and petechiae are the main endoscopic manifestations of PHG in cirrhosis of the liver, while cherry erythema is a characteristic lesion. Hepatic cirrhosis before the formation of portal hypertension, the endoscopic performance of gastric mucosa similar to ordinary chronic gastritis.