关键词: 肝硬化, 食管静脉曲张, 胃底静脉曲张, 超声内镜, 诊断 ,  ,  

Abstract: Objective The aim of this stud was to explore the value of endoscopic ultrasonography (EUS) in the diagnosis of esophageal varices (EV) and gastric fundus varices (GV) in patients with hepatitis B –induced liver cirrhosis. Methods Eighty-nine patients with hepatitis B liver cirrhosis (Child class A in 22 cases, Child class B in 45 cases and Child class C in 22 cases) were included in the Department of Gastroenterology in our hospital between February 2016 and February 2019, and all patients underwent EUS and routine endoscopic examination. The diameters of all varices at the levels of splenic veins and azygos veins in our series were measured by both methods. Results The routine endoscopic examination showed that the prevalence of EV was 46.1%, significantly higher than 28.1% (P<0.05), while the incidence of GV was 30.3%, significantly lower than 39.3%(P<0.05) by EUS; as for the Child classification of liver functions, the prevalence of EV out of patients with Child class B and class C by EUS were 24.4% and 50.0%, significantly lower than 42.2% and 81.8%(P<0.05) by routine endoscopic examination, while in patients with Child class B, the GV prevalence by EUS was 37.8%, significantly higher than 22.2%(P<0.05) by routine endoscopic examination; the diameters of EV and GV by EUS were (7.0±0.7) mm and (6.8±0.6)mm, not significantly different as compared to 【(7.1±0.6)mm and (7.1±0.6) mm, respectively, P>0.05】 by routine endoscopic examination. Conclusion The gastrointestinal hemorrhage risk in patients with liver cirrhosis is high, and the endoscopic examination is the gold approach for the finding of EV and GV. The EUS is a promising supplementary way for the varices examination, especially for GV, which warrants further investigation.

Key words: Liver cirrhosis, Esophageal varices, Gastric fundus varices, Endoscopic ultrasonography, Diagnosis