| Objective 1.To analyze the detection of EGV in patients with cirrhosis and CHB by EUS,and to evaluate the early diagnostic value of EUS for EGV.Patients were followed up by EUS to understand the changes in EGV and to assess the prognosis.2.To investigate the agreement between EUS and portal vein angiography in diagnosis of EGV in patients with liver cirrhosis.Method 1.A total of 116 patients with liver cirrhosis without EGV seen under gastroscope and 182 patients with chronic hepatitis B were examined by EUS,classification was according to the location and degree of varicose vein,to analysia the detection of esophageal and gastric parts of the varicose veins in the two groups of patients.2.Liver cirrhosis group was divided into 3 groups according to Child-Pugh grade,CHB group was divided into 2 groups according to whether the antiviral therapy was used.After 1 year,all the patients were examined by EUS,and the changes of EGV were analyzed before and after follow-up.3.84 patients with liver cirrhosis were selected as the research object,summed up the detected the situation of EUS and CTA on esophageal gastric submucosal and peripheral varicose veins,compare the diagnostic consistency in two groups.Results 1.In cirrhosis group,101 patients can be detected more than one part of the gastroesophageal variceal varicose veins,68 patients can be detected more than two parts of the gastroesophageal variceal varicose veins,21 patients were also detected esophageal submucosal and esophageal varicose veins,30 patients can be detected at the same time gastric submucosal and gastric varicose veins.2.Compared with CHB group,there were significant differences in esophageal and gastric submucosal varices,esophageal and parietal varices,esophageal and gastric varicose veins(P <0.05).There was significant difference in perforator veins between the two groups(P <0.05).3.1 year after the review of EUS,in cirrhosis patients,68 cases of Child A grade with varicose veins did not change significantly,6 patients with varicose veins subsided or reduced,1 patient from Child A progress to Child C.8 patients with Child B grade increased degree of varicose veins,5 patients found a new varicose veins.4 patients with Child C grade increased degree of varicose veins,2 patients found a new varicose veins.4.In HBV antiviral group,23 cases of varicose veins to reduce or subside.In unantiviral group,4 patients with increased degree of varicose veins,6 patients with new varicose veins,1 patient progressed to cirrhosis Child A grade level.5.Compared with portal CTA,EUS was not highly consistent with esophageal varicose veins(P <0.05).EUS and portal vein CTA were highly consistent in the detection rate of varicose veins for esophageal peripheral vein,fundus submucosal vein and peripheral gastric vein(P> 0.05).Conclusion 1.For the cirrhosis and CHB population without varicose veins in the endoscopy,EUS can be found in the esophageal gastric submucosal varices and peripheral varicose veins,which may be useful for the early diagnosis of cirrhosis and the severity of the disease.2.Antiviral therapy can delay the progression of cirrhosis varicose veins,through antiviral therapy can make some patients with early stage of liver fibrosis varicose veins to a certain degree of reversal.However,for Child B-C patients,even if the anti-viral treatment,still can not completely prevent varicose veins.3.In patients without CHB treatment,there may be new EGV or EGV aggravated,or even rapid progress of cirrhosis.4.Antiviral treatment of CHB patients with most of the EGV no change,a very small number of patients with disease progression.5.Monitoring EUS changes in the evaluation of disease progression and prognosis of patients with chronic liver disease has a certain clinical significance.6.Esophageal varicose veins detection rate in EUS was higher than portal CTA.EUS and portal CTA is highly consistent in detection rate with esophageal variceal varicose veins,varicose veins of the gastric fundus and varicose veins of the peripheral gastric veins. |
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