摘要
目的观察不同类型胃曲张静脉(GV)的临床特征、内镜表现及 CT 门静脉血管成像(CTPA)显示的血流特征。方法分析经内镜确诊的 GV 病例50例并分型,比较不同类型的内镜表现及 CTPA 检查结果。结果 50例患者中,GOV-Ⅰ型29例,GV 多为轻度,CTPA 示血流来源以胃左静脉为主,胃肾/脾肾分流者17.2%;GOV-Ⅱ型10例,GV 严重程度不等,CTPA 示多为胃左、胃后、胃短静脉混合供血,有分流者50.0%;IGV-Ⅰ型11例,GV 多为重度,CTPA 示血流来源以胃后、胃短静脉为主,有分流者63.6%。GOV-Ⅱ型和 IGV-Ⅰ型出血发生率高于 GOV-Ⅰ型(P<0.05)。结节形和瘤形的静脉曲张出血发生率高于迂曲形(P<0.01)。结论 Sarin 分型结合内镜下曲张静脉形态可明确胃静脉曲张的严重程度,预测其出血风险性。CTPA 显示不同类型 GV 的血流来源不同,分流发生率不同,因此疗效也有差异。
Objective To investigate the endoscopic features and hemodynamics of gastric varices （GV） by muhi-detector row CT portal angiographies. Methods Fifty patients with GV were endoscopically diagnosed, all of them underwent CT portal angiography （CTPA）. Results According to Satin＇s category of GV,gastroesophageal varices （GOV） -Ⅰ was found in 29 cases , most of them in mild varices, in which the left gastric vein was the predominant route to form the varices. Gastrorenal or splenorenal shunt was found in 5 cases （ 17. 2% ）. GOV-Ⅱ was found in 10 cases. Their degree of varices were different, in which the left gastric vein and the posterior/short gastric veins contributed to the formation of the varices. Gastrorenal or splenorenal shunt was found in 5 cases （50. 0% ）. Isotaled gastric varices（ IGV）-Ⅰ was found in 11cases with severe varices, in which posterior/short gastric veins were the major contributors to form the varices. Gastrorenal or splenorenal shunt was found in 7 cases （63.6%）. Bleeding occurred more common in GOV-Ⅱ and IGV-Ⅰ than in GOV-Ⅰ （ P 〈 0. 05 ）. The bleeding rates were different, in tumorous/nodular types were higher than those in tortuous type （ P 〈 0.01 ）. Conclusion Sarin＇s category and the type of GV are helpful to investigate the degree of gastric varices and predict the risk of bleeding. Because the hemodynamic features and occurrence of shunt were different in these three types, the therapeutic effect may be different.
出处
《中华消化内镜杂志》
2006年第4期241-244,共4页
Chinese Journal of Digestive Endoscopy
关键词
胃静脉曲张
高血压
门静脉
CT门静脉血管成像
Gastric varices
Hypertension,portal
Computerized tomography portal angiography
