【摘要】 目的 观察血吸虫病肝纤维化形成门脉高压性胃病(PHG)的影响因素。方法 回顾性分析近5年来资料完整、胃镜检查证实的血吸虫病肝纤维化门脉高压症食管静脉曲张的住院患者196例(合并PHG 109例)。将PHG的发生率与食管静脉曲张严重程度、肝功能Child Pugh分级的关系作对照。结果 食管静脉曲张轻、中、重度患者的PHG发生率分别为47.7％(21/44)、54.8％(23/42)及59.1％(65/110),比较相互间差异均无显著性意义(P>0.05)。Child Pugh外分级A、B、C级的PHG发生率分别为56.0％(47/84)、53.3％(48/90)及63.6％(14/22),比较相互间差异均无显著性意义(P>0.05)。未经任何手术治疗的PHG发生率为51.3％(61/119),切脾术后为50.0％(19/38),两者间差异无显著性意义(P>0.05)。切脾+断流术后为70.6％(12/17),食管静脉曲张硬化治疗术后为85.0％(17/20),与未经任何手术治疗者间的差异均有显著性意义(P<0.05)。结论 血吸虫病肝纤维化门脉高压症中PHG的发生率与食管静脉曲张严重程度及肝功能Child Pugh分级无关。PHG发生率在切脾+断流术、食管静脉曲张硬化治疗术后增加,而单纯作切脾术后无显著变化。更多还原

【Abstract】 Objective To evaluate the factors influencing the development of portal hypertensive gastropathy(PHG) with liver fibrosis in schistosomiasis japonica. Methods A retrospective study was executed on 196 hospitalizedpatients with schistosomiasis liver fibrosis (109 of them complicated with PHG) from 1998 to 2002. Endoscopic examina-tions were carried out for all the cases. The analysis was made with a comparison of the PHG incidence to the degree ofesophageal varices and the degree of liver function according to Child Pugh’s scores. Results With slight, moderateand severe degree of esophageal varices, the PHG incidence was 47. 7%, 54. 8%, and 59. 1% respectively (P>0. 05).With the Child pugh’s classes of A, B and C, the PHG incidence was 56. 0%, 53. 3%, and 63. 6% respectively (P>0. 05). With no surgical intervention, it was 51. 3%, and with splenectomy, only 50. 0%. With splenectomy plus an oper-ation of transection and an endoscopic sclerotherapy, it was 70. 6% and 85. 0%. The PHG incidence was significantly high-er in the group of splenectomy plus operation of transection and the group with endoscopic sclerotherapy than the group withno surgical intervention (P<0. 05). Conclusion The PHG incidence in schistosomiasis liver fibrosis has no relationshipwith the degree of esophageal varices and Child Pugh classes of liver function. However, splenectomy plus transection andendoscopic sclerotherapy may accelerate the PHG development.更多还原