Sources and Outcome of Upper Gastrointestinal Bleeding in Patients with Portal Hypertension Manifested by Esophageal Varices

以食道靜脈瘤表現之門脈高壓患者上消化道出血之來源及其預後

羅錦河(Gin-Ho Lo) ； 黎國洪(Kwok-Hung Lai) ； 蔡養德(Yang-Te Tsai) ； 李壽東(Shou-Dong Lee) ； 伍偉華(Wai-Wah Ng) ； 林懷正(Hwai-Jeng Lin) ； 譚振熀(Tseng-Nip Tam)

《中華民國消化系醫學會雜誌》 5卷2期 (1988/06) Pp. 51-56

https://doi.org/10.6557/GJTa.198806_5(2).0001

摘要

門靜脈高血壓合併上消化道出血之304例病患，在發生出血後48小時內接受胃內視鏡檢查。出血原因中，74%是食道靜脈瘤破裂，胃潰瘍及十二指腸潰瘍出血各佔10%。另外6%之病患，其出血部位則無法決定。酒精性肝病與非酒精性肝病患者之食道靜脈瘤出血之比率並無不同。49位合併有肝癌之患者，90%出血部位是源於食道靜脈瘤。
這些病患住院當中之死亡率，食道靜脈瘤45%，胃潰瘍及十二指腸潰瘍出血者為23%。酒精性肝病與非酒精性肝病患者，其上消化道出血之死亡率相同。合併肝癌患者上消化道出血之死亡率則爲63%。

關鍵字

門靜脈高血壓 ； 消化道出血 ； 食道靜脈瘤

並列摘要

We examined 304 patients with portal hypertension and acute upper gastrointestinal (UGI) bleeding by emergency endoscopy within 48 hours. Esophagogastric varices (EGV) were identified as the bleeding sources in 74%, gastric ulcer and duodenal ulcer each accounted for 10%, another 6% were undetermined. The frequencies of variceal bleeding from alcoholic liver disease and from nonalcoholic liver disease were similar. In 49 patients associated with hepatocellular carcinoma, 90% of them bled from EGV.
The in-hospital mortality rates for UGI bleeding from esophagogastric varices, gastric ulcer and duodenal ulcer were 45%, 23% and 23% respectively. The in-hospital mortality rates for UGI bleeding from alcoholic liver disease and from nonalcoholic liver disease were similar. The mortality rates of UGI bleeding in patients with hepatocellular carcinoma (HCC) associated with portal hypertension were 63%.

並列關鍵字

portal hypertension ； UGI bleeding ； esophagogastric varices