Articles Vol. 65 No. CĐ10 - Bệnh viện Thống Nhất 30/10/2024

16. SURVEY THE CORRELATION BETWEEN CHILD-TURCOTTE-PUGH CLASSIFICATION AND THE DEGREE OF ESOPHAGEAL VARICES IN CIRRHOTIC PATIENTS

Ha Vu1,2,3,4, Ngo Thi Thanh Quyt2,4
1 University of Health Sciences, Vietnam National University Ho Chi Minh City
2 Thong Nhat Hospital
3 Trường Đại học Khoa học Sức khỏe, Đại học Quốc gia Thành phố Hồ Chí Minh
4 Bệnh viện Thống Nhất
Corresponding author: havudr@gmail.com
DOI: 10.52163/yhc.v65iCD10.1601
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Keywords
Cirrhosis large esophageal varices Child-Turcotte-Pugh classification
Abstract

Background: Upper gastrointestinal bleeding due to ruptured esophageal varices (EV) is one of the leading fatal complications in patients with cirrhosis. Currently, many non-invasive methods have been studied to screen for this complication. However, the correlation between the Child-Turcotte-Pugh (CTP) classification and the degree of EV has not been fully studied, especially in Vietnam.

Objective: To investigate the correlation between the Child-Turcotte-Pugh classification and the degree of EV in patients with cirrhosis.

Subjects and Methods: A cross-sectional descriptive study was conducted on 225 cirrhotic patients at Thong Nhat Hospital. Patients underwent biochemical tests, upper gastrointestinal endoscopy, and abdominal ultrasound. They were classified according to the Child-Turcotte-Pugh scoring system. The study aimed to find the correlation between the presence of large EV (grade 2, grade 3) and the CTP classification.

Results: The rate of EV in the study population was 82.7%, with large EV (grade 2, grade 3) accounting for 60%. The distribution of Child-Turcotte-Pugh classifications A, B, and C were 19.1%, 37.3%, and 43.6%, respectively. In the group with small EV (grade 0, grade 1), Child A patients had the highest proportion (74.4%). In contrast, in the group with large EV (grade 2, grade 3), Child C patients had the highest proportion (76.5%).

Conclusion: The Child-Turcotte-Pugh classification is a valuable non-invasive method for predicting the presence of large EV in patients with cirrhosis.

References
[1]
D 'amico G.,Luca A. “Portal hypertension. Natural history. Clinical-hemodynamic correlations. Prediction of the risk of bleeding”. Bailliers Google Scholar
[2]
Clin.Gastroenterol, 1997,11,243-256. Google Scholar
[3]
Groszmann RJ, Garcia-Tsao G, Bosch J, et al. “Beta-blockers to prevent gastroesophageal varices in patients with cirrhosis”. N Engl J Med.; 2005, 353(21), 2254-2261. Google Scholar
[4]
Trần Quốc Trung, Bùi Hữu Hoàng. “ Tỉ số tiểu cầu/kích thước lách và kích thước gan phải/Albumin trong dự đoán giãn tĩnh mạch thực quản trên bệnh nhân xơ gan”. Tạp chí Y học TPHCM, 2010, Tập 14, số 1, tr. 167 – 172. Google Scholar
[5]
ASGE guideline: The role of endoscopy in the management of variceal hemorrhage, updated July 2005. Google Scholar
[6]
Child CG, Turcotte JG (1964). “Surgery and portal hypertension". The liver and portal hypertension. Philadelphia: Saunders, 1964, 50–64. Google Scholar
[7]
Pugh RN, Murray-Lyon IM, Dawson JL, et al. "Transection of the oesophagus for bleeding oesophageal varices". The British journal of surgery, 1973, 60 (8), 646–649. Google Scholar
[8]
Tafarel JR, Tolentino LH, Correa LM, et al.. “Prediction of esophageal varices in hepatic cirrhosis by noninvasive markers”. Eur J Gastroenterol Hepatol; 2011,23, 754-758. Google Scholar
[9]
Ahmed A. ElNaggar, Mohamed S. Gomaa and May M. Fawzy. “Nonendoscopic predictors of large esophageal varices”. Egyptian Journal of Internal Medicine, 2012, 24, 97–99. Google Scholar
[10]
Angelo Zambam de Mattos, Angelo Alves de Mattos, Larissa. F. Daros, M.I. Musskopf. “Aspartate aminotransferase-to-platelet ratio index (APRI) for the non-invasive prediction of esophageal varices”. Annals of Hepatology. 2013. Vol.12, No.5, 810-814. Google Scholar
[11]
Zoli M – Merkel C, Maglotti D, Gueli C , et al. “Natural history of cirrhotic patients with small esophageal varices: a prospective study”. Am J. Gastroenterol , 1999, 95, 503-508. Google Scholar
[12]
L. Pagliaro, G. D’Amico, L. Pasta, et al. “Efficacy and efficiency of treatments in portal hypertension”. The 2nd Baveno International Consensus Workshop on Definitions, Methodology and Therapeutic Strategies, R. de Franchis, Ed., Portal Hypertension II, 1996, 159–179, Blackwell Science, Oxford, UK. Google Scholar
[13]
Atif Zaman, Hapke R, Flora K, et al. “ Factors predicting the presence of esophageal or gastric varices in patients with advanced liver disease”. Am J Gastroenterol; 1999, 94, 3292-3296. Google Scholar
[14]
Trần Ngọc Lưu Phương, Đặng Thế Việt. “ Các nghiệm pháp không xâm lấn dự báo giãn tĩnh mạch thực quản và dạ dày ở bệnh nhân xơ gan”. Tạp chí Y học TPHCM, 2012, Vol.16, Phụ bản số 3, trang 18 – 22. Google Scholar
[15]
Hồ Tấn Phát. “Khảo sát mối tương quan giữa mức độ xơ gan theo phân loại Child-Pugh và mức độ giãn TMTQ qua nội soi dạ dày tá tràng”. Luận văn Thạc sỹ y khoa, Đại học Y dược TP.HCM. 2003 Google Scholar
[16]
Mã Phước Nguyên. “Mối tương quan giữa tỉ lệ số lượng tiểu cầu trên đường kính lách với giãn TMTQ trên bệnh nhân xơ gan”. Luận văn Thạc sỹ y khoa, Đại Học Y Dược TP.HCM. 2005 Google Scholar