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目的探讨内镜超声检查术(EUS)对门静脉高压(PHT)所致食管胃底静脉曲张(EGV)的诊断价值。方法选择临床确诊PHT并存在EGV的患者53例及对照组20例,均进行电子胃镜和EUS检查,EUS检查主要了解EGV及其他异常静脉情况等。结果胃镜检出53例均有食管静脉曲张(EV),EUS检出29例；胃镜检出胃底静脉曲张(GV)者18例,EUS检出24例。两种方法检出率比较差异有统计学意义(P＜0．001)。EUS共检测出穿通支阳性患者27例(51%),穿通支显示情况在不同F值(内镜下EV形态分级)中的分布差异有统计学意义(P＜0．001)。EUS下监测脾静脉在实验组和对照组直径分别为(11．5±3．5)mm、(7．5±1．35)mm,差异有统计学意义(P＜0．001)。实验组和对照组奇静脉近端直径分别为(8．77±2．94)mm、(7．36±1．29)mm,差异有统计学意义(P＜0．05)。结论EUS对PHT所致的食管胃底静脉曲张有较大的辅助诊断价值,尤其对管壁外的异常静脉检出有重要价值。
Objective To investigate the value of endoscopic ultrasonography (EUS) in the diagnosis of esophagogastric varices (EGV) induced by portal hypertension (PHT). Methods Fifty-three patients with PHT diagnosed with EGV and 20 patients with control group were enrolled in this study. Electro-endoscopy and EUS examination were performed. EUS examination mainly focused on EGV and other abnormal venous conditions. Results Gastroscopy was detected in 53 cases of esophageal varices (EV), EUS detected 29 cases; gastroscopy varicose veins (GV) in 18 cases, 24 cases of EUS detected. The detection rate of the two methods was significantly different (P <0.001). EUS detected 27 cases (51%) of patients with perforation-positive disease. The perforating branches showed statistically significant differences in the distribution of EV values (endoscopic EV morphology classification) (P <0.001). The diameter of splenic vein monitored by EUS was (11.5 ± 3.5) mm and (7.5 ± 1.35) mm in experimental group and control group, respectively. The difference was statistically significant (P <0.001). The diameters of the proximal auricus in experimental group and control group were (8.77 ± 2.94) mm and (7.36 ± 1.29) mm, respectively, with statistical significance (P <0.05). Conclusion EUS has great value in the diagnosis of esophagogastric varices caused by PHT, especially for abnormal venous detection outside the wall.