摘要
目的 探讨肝炎后肝硬化的流行病学和临床特点 .方法 对 5 46例肝炎后肝硬化的住院病例进行回顾性调查分析 .结果 肝炎肝硬化年龄主要分布在 31～ 6 0岁 ,男女比例为 4.31∶ 1;单纯乙肝后肝硬化 430例 ,占 78.8% ,乙肝重叠其他肝炎病毒者 84例 ,占 15 .4% ;肝炎反复发作者较不发作者发展为肝硬化的时间明显缩短 ;胃镜检查发现 84.1%的肝炎肝硬化患者有食管胃静脉曲张 ,B超声显示 7.9%的肝硬化患者脾体积正常 ;门脉高压胃病发生率随食管静脉曲张程度增加 ,30 .8%的门脉高压胃病发生于无食管胃静脉曲张者 ;114例上消化道出血者中 ,食管胃静脉曲张破裂出血者占31.0 % ,门脉高压胃病及消化性溃疡出血分别占 6 1.9%和7.1% .结论 乙肝后肝硬化是我国肝炎肝硬化主要类型 ;同时进行 B超声和胃镜检查有助于提高肝硬化的诊断率 ;门脉高压胃病发生受门脉高压和肝损害程度影响 ;
AIM To investigate the epidemiologic and clinical features of the patients with posthepatitic cirrhosis. METHODS By retrospective analysis, 546 in-patients with posthepatitic cirrhosis were studied. RESULTS The age of cases was predominantly 31~60, with a sex ratio of 4.31(M):1(F). 430 cases were determined as hepatitis B, accounting for 78.8 percent of the patients. 84 cases suffered from hepatitis B superinfecting other hepatitic viruses, holding 15.4 percent of all patients. The period for the patients with recurrent hepatitis to evolve to liver cirrhosis was significantly shorter than that for the patients with no relapse. Gastroesophageal varices were discovered in 84.1 percent of the patients by gastroscopy. Normal size of spleens was confirmed in 7.9 percent of all cases by type B ultrasonography. The incidence of portal hypertensive gastropathy increased with size of esophageal varices. There is 30.8% percent of portal hypertensive gastropathy in the patients without gastroesophageal varices. Of 114 cases with upper gacstrointestinal bleeding, that of 31.0 percent of patients resulted from gastroesophageal varices, while 61.9 and 7.1 percent of cases were due to portal hypertensive gastropathy and peptic ulcer respectively. CONCLUSION The posthepatitis B cirrhosis is a main type of cirrhosis in China. Simultaneous examination of ultrasonography and gastroscopy contributes to enhancing diagnosis of liver cirrhosis. Development of portal hypertensive gastropathy is influenced by portal hypertension and severity of liver disease. Portal hypertensive gastropathy and gastroesophageal varices are important factors of upper gastrointestinal bleeding.
出处
《第四军医大学学报》
2000年第7期820-823,共4页
Journal of the Fourth Military Medical University
