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DOPPLER SURROGATE ENDOSCOPY FOR SCREENING ESOPHAGEAL VARICES IN PATIENTS WITH CIRRHOSIS

机译:多普勒超声内窥镜检查对肝硬化患者食管静脉曲张的筛查

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Background: Portal hypertension is a common consequence of hepatic cirrhosis, which causes esophageal varices. Bleeding from varices has a high mortality rate. The present gold standard for diagnosing varices is endoscopy. Considering endoscopy side effects and patients' low acceptance, there have been always efforts for finding alternative diagnostic methods including Doppler ultrasonography (US).Objectives: The aim of the present study was to evaluate changes of Doppler indices in cirrhotic patients with and without esophageal varices.Patients and Methods: Sixty six patients with known cirrhosis entered this cross-sectional study. Gastroscopy was performed for patients, and the first questionnaire was filled based on the Japanese Portal Hypertension Society guidelines. Then patients were referred for Doppler US of splenoportal system, and information was documented in the second questionnaire.Results: Forty-four patients were male and 22 female. Forty six patients had esophageal varices, and 20 did not. There were no significant associations between splenoportal indices found by Doppler US, and presence of esophageal varices in patients. However, we found a negative association between platelet ratio to spleen diameter, and to splenic vein diameter.Conclusions: Neither of studied variables was perfect to differentiate cirrhotic patients with and without EVs. Endoscopy is still the gold standard diagnostic method for diagnosing esophageal varices in patients with cirrhosis. It seems that some of the splenoportal Doppler indices are promising, but more research and evaluation is necessary.
机译:背景:门静脉高压症是肝硬化的常见后果,会引起食管静脉曲张。静脉曲张破裂出血的死亡率很高。目前诊断静脉曲张的金标准是内窥镜检查。考虑到内窥镜检查的副作用和患者的接受度低,一直在努力寻找其他诊断方法,包括多普勒超声检查。目的:本研究的目的是评估有无食管静脉曲张的肝硬化患者的多普勒指数变化。患者和方法:六十六例已知肝硬化的患者参加了这项横断面研究。对患者进行了胃镜检查,并根据日本门诊高血压学会指南填写了第一份问卷。然后将患者转诊为脾门系统的多普勒超声,并在第二份问卷中记录信息。结果:44例患者中男性22例。 46例患者有食管静脉曲张,而20例则没有。多普勒超声发现的脾门指数与患者食管静脉曲张之间无显着相关性。然而,我们发现血小板比率与脾脏直径以及脾静脉直径之间存在负相关。结论:这两个研究变量均不能完美区分有和没有EV的肝硬化患者。内窥镜检查仍然是诊断肝硬化患者食管静脉曲张的金标准诊断方法。某些脾门多普勒指数似乎很有希望,但是还需要更多的研究和评估。

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