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目的研究肝硬变患者食管胃运动功能的改变及其与上消化道出血的关系。方法采用单光子发射型机算机断层显像法对40例肝硬变患者和18例正常人的胃食管反流(GER)和胃液体排空(GE)时进行了检查。结果①肝硬变GER阳性率(42.5%)明显高于正常组(11.1%,P<0.05)。②肝硬变胃液体半排空时(GET_(1/2))平均值(33.70±5.57 min)极明显高于正常组(19.25±7.06 min,P<0.01);肝硬变胃液体排空迟缓发生率为60%,正常组为20%(P<0.05)。③肝硬变GER~+组上消化道出血和腹水的发生率分别为88.2%和94.1%,GER~-组为47.8%和60.9%(P<0.05)。随访1年,GER~+组平均出血次数(1.78±1.12)高于GER~-组(0.94±0.8,P<0.05)。结论肝硬变患者GER发生率增高,胃排空迟缓,且GER~+与上消化道出血关系密切。
Objective To study the changes of esophagogastric motor function in patients with cirrhosis and its relationship with upper gastrointestinal bleeding. Methods Single photon emission computed tomography was used to examine gastroesophageal reflux (GER) and gastric fluid emptying (GE) in 40 cirrhotic patients and 18 normal controls. Results ① The positive rate of GER in cirrhosis (42.5%) was significantly higher than that in normal group (11.1%, P <0.05). (2) The mean value of GET_ (1/2) in cirrhotic gastric juice was significantly higher than that in normal control group (33.70 ± 5.57 min vs 19.25 ± 7.06 min, P <0.01) Delayed onset was 60% in the normal group 20% (P <0.05). ③ The incidence of upper gastrointestinal bleeding and ascites in GER ~ + group was 88.2% and 94.1%, respectively, and 47.8% and 60.9% in GER ~ - group (P <0.05). The average number of bleeding in GER ~ + group (1.78 ± 1.12) was higher than that in GER group (0.94 ± 0.8, P <0.05). Conclusion The incidence of GER in patients with liver cirrhosis is increased, and the gastric emptying is slow. GER ~ + is closely related to upper gastrointestinal bleeding.