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[肝硬化患者食管和胃静脉曲张形成的发病机制]

[Pathogenesis of esophageal and gastric varicose veins formation in patients with liver cirrhosis].

作者信息

Shertsinger A G, Manuk'ian G V, Manuk'ian V G, Cherkasov V A, Zhigalova S B, Khovrin V V, Aliev Kh Kh, Tsaava D V

出版信息

Eksp Klin Gastroenterol. 2011(6):73-8.

Abstract

RESEARCH OBJECTIVE

studying the features of the collateral venous blood flow and the basic ways of the formation of gastroesophageal varices in patients with cirrhosis and portal hypertension.

METHODS

The following analysis is based on the interpretation of results from percutaneous transhepatic splenoportography in 85 patients. It has been established that in all 85 patients the left gastric vein plays a key role in the formation of gastroesophageal varices.

RESULTS

It is established that a leading collector in 100% of observations participating in formation gastroesophageal varices, is the left gastric vein. In work the attention is focused on an insufficient estimation of a role of a back gastric vein in a pathogenesis of varicose transformation. From 85 observations its presence is taped in 58 (68%) cases, and, at 19 (22%) patients its expansion isn'ted in a combination to expansion left gastric vein, and at 39 (46%) patients - in a combination with left gastric vein and short veins of a stomach.

CONCLUSION

The obtained data on the formation mechanism of varicose expanded veins of an esophagus and a stomach defines necessity of changes for algorithm of inspection of patients for the purpose of diagnostics of features of a venous blood flow of a stomach and an esophagus and definition of surgical tactics concerning volume pre- or intraoperational blockade of the basic venous collectors.

摘要

研究目的

研究肝硬化和门静脉高压患者侧支静脉血流特征及胃食管静脉曲张形成的基本途径。

方法

以下分析基于对85例患者经皮经肝脾门静脉造影结果的解读。已证实,在所有85例患者中,胃左静脉在胃食管静脉曲张的形成中起关键作用。

结果

已确定,在参与胃食管静脉曲张形成的100%观察中,主要收集器是胃左静脉。在研究中,注意力集中在对胃后静脉在静脉曲张转变发病机制中的作用估计不足。在85例观察中,58例(68%)发现其存在,19例(22%)患者其扩张与胃左静脉扩张同时出现,39例(46%)患者其扩张与胃左静脉和胃短静脉扩张同时出现。

结论

所获得的关于食管和胃静脉曲张扩张形成机制的数据确定了改变患者检查算法的必要性,以诊断胃和食管静脉血流特征并确定关于基本静脉收集器术前或术中大容量阻断的手术策略。

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