鼻胃镜与普通胃镜对老年患者上消化道疾病诊治的临床对照研究

目的 评价鼻胃镜与普通胃镜应用于老年患者上消化道疾病诊疗的耐受性、临床价值及安全性.方法 对有上消化道疾病的116例老年患者（≥60岁）分别予以鼻胃镜、普通胃镜检查（每组各58例）,对患者胃镜检查前、中、后的收缩压、舒张压、心率、呼吸频率、血氧饱和度及检查过程中的不适反应进行观察.结果 普通胃镜组收缩压、舒张压、心率较检查前有显著性升高,差异有统计学意义（P＜0.05）,血氧饱和度和呼吸频率无明显变化（P＞0.05）;鼻胃镜组患者收缩压、舒张压、心率与检查前比较升高,血氧饱和度及呼吸频率略低于检查前,但差异均无统计学意义（P＞0.05）.鼻胃镜组患者视觉模拟评分法（VAS）痛苦评分低于普通胃镜组,差异有统计学意义（P＜0.01）.结论 鼻胃镜的安全性及耐受性均优于普通胃镜,对于不能耐受普通胃镜检查的老年患者,鼻胃镜不失为一种安全、可行的内镜检查方法.     

无痛内镜下行食管静脉曲张套扎术疗效观察

目的观察无痛胃镜下行食管静脉曲张套扎术与普通胃镜下行食管静脉曲张套扎术患者的反应及效果。方法观察无痛胃镜下行食管静脉曲张套扎术37例，普通内镜下行食管静脉曲张套扎术5例，观察术中及术后患者的反应及效果。结果无痛胃镜下行食管静脉曲张套扎术患者术中无痛苦，操作稳定性好，套扎成功率高，术后患者无操作知觉，患者恢复良好，无并发症发生。普通内镜下行食管静脉曲张套扎术术中均有不同程度的痛苦，以恶心、胸痛为主要表现，其中2例因不能耐受而终止套扎术，1例患者在手术后1周内发生圈套器脱落，虽未发生消化道出血，但使手术风险增加。结论在无痛胃镜下行食管静脉套扎术安全、有效、稳定性好，成功率高，术后手术风险低，患者除出现一过性胸痛外无其他特殊不适感，易于患者接受和提高疗效，适合在临床应用和推广。     

无痛胃镜134例临床应用体会

目的研究异丙酚和咪唑安定在胃镜检查中的麻醉效果及安全性。方法随机分为无痛胃镜组（134例次）和普通胃镜组（166例次）。无痛胃镜组咽部喷雾2％的利多卡因后，静脉注射咪唑安定和异丙酚，意识消失后，立即进行胃镜检查。普通胃镜组只给予咽部喷雾2％的利多卡因后进行检查。两组患者在胃镜检查中均监测血压、心率、呼吸及氧饱和度的变化，观察术中患者的反应、并发症及医生对胃镜视野清晰、食管蠕动的满意度。结果无痛胃镜组患者无明显不适，未出现难以耐受的不适，咳嗽、恶心、呕吐均较普通胃镜组明显减少（P〈0．05）；无痛胃镜组术中血压有不同程度的下降，均为一过性。两组患者氧饱和度均有不同程度的下降，与进镜前比较，差异有统计学意义（P〈0．05），但两组间比较无显著变化（P〉0．05）。无痛胃镜组患者的心率明显的减慢，与普通胃镜组比较差异有统计学意义（P〈0．05）。结论无痛性胃镜术是一种安全、舒适、有效、简便易行的好技术、好方法。     

内镜下套扎联合组织胶注射治疗食管静脉曲张破裂出血的临床疗效

目的:探讨内镜下套扎联合组织胶注射治疗食管静脉曲张破裂出血的临床疗效.方法:选取2007-01/2013-03来武汉市第三医院进行治疗的肝硬化食管胃底静脉曲张出血患者229例,根据治疗情况将患者分为三组:硬化剂联合组织胶治疗组65例、保守治疗组76例及组织胶注射联合套扎术治疗组88例,观察以上三组的临床疗效;按是否行无痛胃镜将组织胶注射联合套扎术治疗组分为无痛组46例、普通组42例,分析手术前后心率(heart rate,HR)、血压(blood pressure,BP)及血氧饱和度(SpO2)指标.结果:不同治疗组间一般疗效指标的比较:组织胶注射联合套扎术治疗组的近期出血6例(6.8%),远期出血8例(9.0%),并发症发生2例(2.3%),死亡3例(3.4%),除并发症发生率(保守治疗组无并发症发生),组织胶注射联合套扎术治疗组的疗效指标数值均小于保守治疗组及硬化剂联合组织胶组.组织胶注射联合套扎术治疗组与硬化剂联合组织胶组相比,远期出血率、并发症发生率及死亡率的差异有统计学意义(P0.05).组织胶注射联合套扎术治疗组与保守治疗组相比,近期出血率、远期出血率及死亡率的差异有统计学意义(P0.05).不同治疗组间内镜下疗效指标的比较:组织胶注射联合套扎术治疗组显效57例(64.8%),有效21例(23.8%),无效10例(11.3%),总效率88.6%.与其他两组相比,显效率和总效率明显提高且差异有统计学意义(P0.05).无痛组和普通组手术前后心率和血氧饱和度无明显统计学差异,无痛组手术后血压低于普通组(P0.05).结论:内镜下组织胶注射联合套扎术的治疗效果较好,而且并发症和死亡率均较低,总有效率较高,是食管胃底静脉曲张破裂出血的首选止血方式.     

异丙酚静脉全凭麻醉在老年无痛消化内镜检查中的临床应用

目的探讨异丙酚静脉全凭麻醉在老年无痛消化内镜诊疗中的有效性和安全性。方法选择在我院门诊同期行消化内镜检查的≥60岁老年患者分为2组,行无痛内镜的患者入A组,行常规内镜的患者入B组,每组60例。A组患者给予异丙酚2.0mg/kg,20s内缓慢注入,以睫毛反射消失进行诊疗,后视手术时间长短和患者的反应,可每次酌情追加20～30mg,诊疗结束后停药。B组患者行普通内镜检查,记录2组患者术前、术中、术毕和清醒时的收缩压（SBP）、舒张压（DBP）、心率（HR）、血氧饱和度（SpO2）的变化,以及并发症和医生患者满意度。结果 A组术中SBP、DBP、HR与术前相比有所降低（P〈0.05）,而B组术中SBP、DBP、HR与术前相比有所增高,2组间术中比较差异有显著性（P〈0.05）;2组SpO2在术中均下降,B组较A组下降明显（P〈0.05）。A组并发症发生率较B组明显减少,且A组患者满意度及医生操作满意度明显高于B组（P〈0.05）。结论异丙酚全凭静脉麻醉对老年内镜诊疗患者的循环、呼吸抑制小,快速诱导与清醒,在老年消化内镜诊疗麻醉中安全有效。     

异丙酚联合小剂量麻黄碱在无痛胃镜诊疗中安全性分析

目的探讨异丙酚联合小剂量麻黄碱在无痛胃镜诊疗中的有效性及防止循环呼吸抑制方面的安全性。方法将300例拟行无痛胃镜检查的患者随机分为对照组和观察组,每组150例,两组均用异丙酚静脉注射进行全身麻醉,异丙酚用量为1.8mg/kg,观察组静脉注射麻黄碱用量为0.18mg/kg。记录两组术前、术中及术后的收缩压（SBP）、舒张压（DBP）、心率（HR）、血氧饱和度（SpO2）的变化以及并发症和医生患者满意度。结果观察组与对照组之间的临床相关指标比较,两组术中SBP、DBP、HR差异有统计学意义（P〈0.05）,SpO2差异无统计学意义（P〉0.05）。结论异丙酚联合小剂量麻黄碱对无痛胃镜诊疗患者的循环、呼吸抑制小,快速诱导与清醒,在无痛胃镜中更加安全有效。     

198例老年患者无痛胃镜和无痛肠镜检查的临床分析

目的 探讨老年人无痛胃镜及无痛肠镜检查的安全性、可行性及效果.方法 对96例老年无痛胃镜组及102例老年无痛肠镜组,同期和同年龄段普通胃镜组90例及普通肠镜组98例,同期90例青中年无痛胃镜及94例青中年无痛肠镜组,在检查过程中观察患者生命体征、血氧饱和度、患者感受及不良反应. 结果 普通胃镜和普通肠镜组患者血压升高和心率增快的例数明显高于相应的无痛胃镜组及无痛肠镜组,尤其原有高血压及冠心病的患者增高更明显,普通内镜组原有高血压患者检查过程中血压升高者占86.7%～91.3%,而无痛内镜组无1例血压升高;普通内镜组原有冠心病患者检查过程中,心率增快者占90.0%以上,无痛内镜组原有冠心病患者心率增快仅占10%左右,差异有统计学意义(P＜0.05).无痛内镜老年组与无痛内镜青中年组的各项指标改变,差异均无统计学意义(P＞0.05),各组呼吸加快和血氧饱和度下降,差异均无统计学意义(P＞0.05).不良反应:无痛胃镜组恶心、呕吐、贲门撕裂等不良反应明显低于普通胃镜组(P＜0.05),呃逆、呛咳等稍高于普通胃镜组(P＞0.05),无痛肠镜组的腹痛、腹胀等不良反应明显低于普通肠镜组(P＜0.05),而老年组与青中组比较差异无统计学意义(P＞0.05).无痛胃镜及无痛肠镜患者感受明显好于普通组(P＜0.05),检查成功率达100%.结论 老年患者在严密监测下行无痛胃镜及无痛肠镜检查安全、舒适、可行.     

高龄老年高血压患者无痛胃镜检查安全性分析

目的观察高龄老年高血压患者无痛胃镜检查时生命体征及术中反应,探讨高龄老年高血压患者行无痛胃镜检查的安全性。方法选取北京老年医院接受胃镜检查的≥80岁老年高血压患者100例,分为试验组（无痛胃镜组）50例,对照组（常规胃镜组）50例,比较两组患者胃镜检查时心率（HR）、收缩压（SBP）、舒张压（DBP）、血氧饱和度（SaO,）变化操作时间（麻醉后行胃镜检查时间）及术中反应。结果胃镜检查中试验组患者SBP、DBP、HR和Sa02显著下降（均P〈0．01）,术后均可恢复正常,对照组患者SBP、DBP、HR均较前显著升高（均P〈0．01）,Sa02显著下降（P〈0．01）,检查中试验组Sa02高于对照组Sa02,但差异无统计学意义（P〉0．05）,试验组胃镜操作时间较对照组稍短,差异无统计学意义（P〉O．05）,试验组不良反应明显低于对照组,差异有统计学意义（P〈0．01）,试验组舒适度明显高于对照组,差异有统计学意义（P〈O．01）。结论高龄老年高血压患者行无痛胃镜检查是安全、舒适的。     

心电监测下老年冠心病患者胃镜检查的安全性分析

目的通过观察老年患者胃镜检查时生命体征的变化,探讨老年冠心病患者胃镜检查的安全性。方法选择在我院接受胃镜检查的60岁以上老年患者60例,分为冠心病组（术前有轻度sT-T改变或有过心绞痛或陈旧性心肌梗死病史,无呼吸系统疾病）30例,对照组（无基础心脏疾病）30例,比较两组老年患者胃镜检查时的心率、血压、血氧饱和度（Sp02）以及心电图变化。结果两组患者心率胃镜术中与术前比较均升高（P〈0．05）,相对变化值两组间比较有统计学差异（P〈0．05）;两组患者收缩压和舒张压胃镜术中与术前相比均有升高（P〈0．05）,组间比较无统计学差异（P〉0．05）;冠心病组患者Sp02胃镜术中较术前出现下降（P〈0．05）,但与对照组比较无统计学差异。二组均出现心律失常,但无危险性心律失常;冠心病组中6例患者出现ST段改变,术后恢复正常。结论对于老年冠心病患者,在术前进行充分准备,必要时术中心电监测,胃镜检查是安全的。     

无痛肠镜和普通肠镜检查应用于老年患者的效果及安全性比较

目的比较老年患者应用无痛肠镜和普通肠镜检查的效果和安全性。方法选择2013年1月至2014年8月该院门诊和住院接受肠镜检查的老年患者100例,按照检查方法分为无痛肠镜组54例和普通肠镜组46例,分别进行无痛肠镜和普通肠镜检查,比较两组检查前和检查过程中血压、心率、血氧饱和度变化及操作时间、成功率和不良反应。结果无痛肠镜组患者检查中收缩压、舒张压、心率和血氧饱和度与检查前比较无统计学意义(P0.05),但显著低于普通肠镜组(P0.05),普通肠镜组患者检查中收缩压、舒张压、心率较检查前显著升高(P0.05),血氧饱和度与检查前比较无统计学差异(P0.05);两组操作时间比较无统计学差异(P0.05),无痛肠镜组成功率、恶心呕吐、头疼、心动过缓发生率高于普通肠镜组,但差异无统计学意义(P0.05),腹胀、腹痛发生率显著低于普通肠镜组义(P0.05)。结论无痛肠镜检查对于老年患者具有良好的安全性,患者在接受检查时不良反应较低,值得临床推广。     

Combined endoscopic and radiologic intervention to treat esophageal varices

BACKGROUND/AIMS: In patients with esophageal varices, we investigated the impact on long-term outcome of combining interventional radiologic procedures with endoscopic therapy. METHODOLOGY: Of 133 patients with esophageal varices, 86 were treated with endoscopic therapy alone and 47 underwent endoscopic therapy in addition to interventional radiologic procedures. End-points considered during 5-years of follow-up included recurrent bleeding and retreatment. RESULTS: Bleeding rates were 24.4% in the endoscopy group and 25.4% in the combined therapy group. Retreatment rates at 1, 3, and 5 years for the endoscopy group versus the combined therapy group were 40.7% versus 30.3%, 72.0% versus 67.5%, and 88.2% versus 80.5%, respectively, representing no significant difference between two groups. However, cumulative retreatment rates in Child's class C cases were significantly lower in the combined therapy group than in the endoscopy group (P = 0.025). Patients who had combined therapy which included all embolizing techniques showed significantly lower retreatment rates than patients treated with endoscopy alone (P = 0.05). CONCLUSIONS: In combination, interventional radiologic and endoscopic therapies are highly effective and can improve long-term outcome in patients with esophageal varices, especially those with poor liver function and those who undergo embolization by all techniques.     

多层螺旋CT门静脉血管成像与内镜对食管、胃静脉曲张诊断的比较研究

目的对比研究多层螺旋CT门静脉血管成像(CTP)和内镜对食管、胃静脉曲张的诊断。方法采用16排多层螺旋CT门静脉血管成像,对57例临床和实验室检查提示门静脉高压的患者进行CTP,观察门静脉及其分支走形、分布,并结合横断面图像仔细观察食管和胃有无静脉曲张,并记录其部位、曲张静脉深浅、观察曲张静脉来源、有无其他部位曲张静脉或其他病理情况。同期对这些病例行胃镜检查,观察食管、胃是否存在静脉曲张及其他病变。结果CTP显示食管及胃静脉曲张病例51例,其中胃底静脉曲张合并食管静脉曲张39例,单纯胃底静脉曲张9例,胃底静脉曲张合并胃体静脉曲张3例。内镜发现食管及胃底静脉曲张46例,其中胃静脉曲张合并食管静脉曲张24例,单纯胃静脉曲张5例,单纯食管静脉曲张17例。CTP可发现内镜无法诊断的肌层或管腔外静脉曲张。结论CTP可清晰显示门静脉高压患者食管、胃底静脉曲张及主要侧支血管的走行、分布。在食管静脉曲张检查方面,CTP与内镜效果相当,CTP有几例假阳性,可作为普通内镜检查的良好补充;对于胃静脉曲张的检查,CTP效果较胃镜敏感,且CTP可清晰显示内镜无法观察的胃腔周围和食管周围静脉曲张。     

Interventional radiology and endoscopic therapy for recurrent esophageal varices

BACKGROUND/AIMS: We investigated the impact long-term prognosis of combined interventional radiology and endoscopic therapy in patients with esophageal varices. METHODOLOGY: Patients with recurrent esophageal varices underwent treatment as follows: 54 were treated with endoscopic therapy alone and 32 underwent endoscopic therapy plus interventional radiologic procedures. Primary endpoints during 5-year follow-up included recurrent bleeding, second retreatment, and death. RESULTS: The bleeding rates were 11.1% in the endoscopy group, and 9.4% in the combined therapy group. Second retreatment rates at 1 year, 3 years, and 5 years in the endoscopy group and combined therapy group were 25.4% and 17.2%, 70.2% and 39.3%, and 85.0% and 69.6%, respectively. The second retreatment rates in the combined therapy group were significantly reduced compared to the endoscopy alone group (P = 0.05). Cumulative retreatment rates in Child's class C cases were significantly lower in the combined therapy group than in the endoscopy group (P = 0.01). Survival at 3 years was 97.1% in the endoscopy group and 92.0% in the combined therapy group, and 5-year survival was 79.1% and 83.6%, respectively. CONCLUSIONS: The combination of interventional radiologic and endoscopic therapy is highly effective and improves long-term prognosis in patients with recurrent esophageal varices.     

Bacteremia after endoscopic injection sclerosis

Endoscopic injection sclerosis is a therapeutic alternative in the management of esophageal varices. Complications of sclerotherapy have been minor, including fever, bacteremia, and abnormal chest x-ray. We performed a prospective study to evaluate the frequency of postsclerosis bacteremia. Bacteremia was detected in 14 procedures (50%). There were no cases of bacteremia in a group of control patients with esophageal varices undergoing upper gastrointestinal endoscopy without sclerosis (p less than 0.05). Bacteremia was transient and unrelated to the presence of fever or other clinical complications. The organism most commonly cultured from blood, alpha-hemolytic streptococcus, probably represents a contaminant from the oropharynx, introduced into the bloodstream during sclerosis. We conclude that injection sclerotherapy of esophageal varices is associated with a higher incidence of bacteremia than routine upper endoscopy and that selected patients may require antibiotic prophylaxis when undergoing this procedure.     

A comparative study of esophageal varices by endoscopy and percutaneous transhepatic esophageal phlebography

Twenty patients with portal hypertension due to cirrhosis were examined by esophagoscopy and percutaneous transhepatic esophageal phlebography. Esophageal varices were found in 18 cases at endoscopy and in 19 cases at esophageal phlebography. There was little correlation between the findings of the two methods with respect to the size and number of esophageal varices. At endoscopy the subepithelial and submucosal varices were reliably detected. At esophageal phlebography differentiation between intrinsic (i.e. subepithelial and submucosal veins) and peri-esophageal veins was not possible. Negative findings at esophageal phlebography do not rule out esophageal varices.     

Improvement of collateral vessels in the vicinity of gastric cardia after endoscopic variceal ligation therapy for esophageal varices.

BACKGROUND & AIMS: Endoscopic variceal ligation (EVL) therapy has been performed widely to treat or prevent variceal bleeding. We sought to examine the influence of EVL for esophageal varices on collateral vessels in the vicinity of gastric cardia. METHODS: In 42 patients with esophagogastric varices, conventional endoscopy and endoscopic ultrasonography with a 20-MHz probe (CUP-EUS) were performed before and at every 3 months after EVL for esophageal varices. By using conventional endoscopy, cardial variceal sizes were divided into 3 grades: F0, F1, and F2. The sizes of submucosal, perforating, and paracardial vessels at the cardia also were classified into 3 grades according to CUP-EUS findings. RESULTS: Conventional endoscopy showed cardial varices in 33 (79%) patients before and 23 (55%) patients at 3 months after the treatment (P < 0.05). CUP EUS showed that 29 (69%) patients had severe grade cardial submucosal vessels before EVL, but only 13 (31%) patients did after the treatment (P < 0.01). Nineteen (45%) patients had severe grade cardial perforating vessels before EVL, but only 4 (10%) patients did after the treatment (P < 0.001). Furthermore, patients with severe grade residual submucosal or perforating vessels at the cardia had shorter recurrence-free times of esophageal varices (P < 0.01, 0.05, respectively). CONCLUSIONS: Collateral vessels in the vicinity of gastric cardia were improved significantly after EVL, indicating that esophageal varices can be treated by EVL even though they connect with cardial varices. Furthermore, eradication of such collateral vessels by EVL may lead to longer recurrence-free status of esophageal varices.     

Lamivudine treatment-related morphological changes of esophageal varices in patients with liver cirrhosis

Aim: Many studies have reported the therapeutic effects of lamivudine on cirrhotic patients with hepatitis B; however, no study has investigated the morphological changes of esophageal varices after lamivudine treatment. Method: The morphological changes of esophageal varices in patients with cirrhosis were retrospectively compared between 12 patients treated with lamivudine and six historical untreated patients. Results: In the treated group, the HBV DNA and hyaluronic acid (HA) levels in the serum were significantly lower than those in the untreated group (P = 0.013 and P = 0.009, respectively) at the end of follow-up, with a significant improvement in the Child-Pugh-Turcotte score (P = 0.022). In the treated group, the disappearance or reduction of esophageal varices was observed in six (50%) of the 12 patients. In three (25%) of the 12 patients, esophageal varices worsened. In the remaining three patients (25%), there were no changes in esophageal varices. In the untreated group, all patients showed the worsening of esophageal varices during the follow-up period, with a significant difference between this group and the treated group (P = 0.009). The serum HA level decreased in the nine treated patients without worsening of esophageal varices. However, in the three patients with worsening, the HA level significantly increased. Conclusion: Lamivudine treatment for patients with cirrhosis improves not only liver function but also esophageal varices.     

The value of Doppler-ultrasonography and laboratory tests as non-invasive predictors of the presence of esophageal varices in patients with chronic liver disease]

BACKGROUND/AIMS: Upper gastrointestinal endoscopy is usually recommended for the evaluation of esophageal varices in patients with liver cirrhosis. However, the prevalence of varices is extremely variable. We performed this study to determine the predictive values for esophageal varices and to select eligible patients for screening endoscopy. METHODS: Fifty-two patients were enrolled in this study. Laboratory tests including liver biochemistry and complete blood count along with ultrasonography with Doppler measurements and endoscopy were performed. RESULTS: Esophageal varices were present in 25 patients (48%). Variables associated with the presence of esophageal varices on univariate analysis were serum albumin, total bilirubin, prothrombin time and platelet count (p<0.05). Significant variables in ultrasonography with Doppler measurement were diameter of spleen (13.04+/-2.1 cm vs. 10.39+/-1.6 cm, p<0.001), peak velocity of portal vein (30.2+/-7.5 cm/sec vs. 36.1+/-8.0 cm/sec, p<0.01) and portal vein diameter (1.26+/-0.28 cm vs. 1.13+/-0.18 cm, p<0.05). On multivariate analysis, independent variables were platelet count (odds ratio (OR) 0.922; 95% confidence interval (CI), 0.86-0.99), diameter of spleen (OR 5.4; 95% CI, 1.63-17.88) and platelet count/spleen diameter ratio (OR 1.007; 95% CI, 1.01-1.02). The optimal critical value for the diameter of spleen was 11 cm. The sensitivity and specificity with this value were 84% and 63%, respectively. CONCLUSIONS: Doppler measurement was not helpful in distinguishing the presence of varices. However, clinical tests including biochemistry and ultrasonography would be useful in selecting eligible patients for screening endoscopy. Endoscopic screening for esophageal varices is recommended in cirrhotic patients with splenomegaly.     

食管胃底静脉曲张血供与侧支的研究

目的通过多层螺旋CT(multi—detecter row computed tomography，MDCT)了解食管胃底静脉曲张及与之相关的侧支循环，为食管胃底静脉曲张破裂出血治疗方案的选择和预后的判断提供客观依据。方法选择51例临床证实的肝硬化门静脉高压患者，其中胃镜显示食管静脉曲张51例，伴胃底静脉曲张31例。对所有患者进行MDCT血管成像，重点观察食管胃底静脉曲张及相关侧支循环。结果MDCT血管成像能清晰地显示肝硬化门体侧支血管，并显示所有食管静脉曲张。MDCT显示胃底静脉曲张32例(62．7％)，与胃镜检查结果(31／51，60．8％)比较，两者具有高度一致性，Kappa值为0．876。食管曲张静脉几乎全部由胃左静脉供血，30例(58．8％)单纯由胃左静脉前支供血，21例(41．2％)伴有食管旁静脉；24例(75％)胃底曲张静脉为单纯胃左静脉供血，3例(9．4％)由胃短(胃后)静脉供血，5例(15．6％)为胃短(胃后)和胃左静脉双重供血，双重供血者因胃底静脉曲张和食管静脉曲张常相互交通，所以这些病例胃短(胃后)静脉也同时参与食管静脉曲张的形成。结论MDCT能较清晰地显示食管胃底静脉曲张侧支循环。食管静脉曲张主要由胃左静脉供血，大部分由前支经贲门进入曲张静脉，部分伴有食管旁静脉。胃底静脉曲张大部分由胃左静脉供血，但小部分则由胃短系统供血。     

无创标志物对原发性胆汁性胆管炎患者食管胃底静脉曲张的预测价值

目的 评价无创指标预测原发性胆汁性胆管炎(PBC)患者发生食管胃底静脉曲张的价值.方法 回顾性分析2017年1月至2020年9月在中国人民武装警察部队特色医学中心就诊并接受胃镜检查的106例PBC患者的临床资料,以内镜检查为金标准,将患者分为静脉曲张组(n=54)和无静脉曲张组(n=52).比较患者的生化学、超声检查指...