超声检查诊断肝硬化门静脉高压症临床价值研究

doi:10.3969/j.issn.1672-5069.2016.04.017

摘要/Abstract

摘要： 目的研究超声检查在肝硬化门静脉高压症诊断中的临床价值。方法选择2008年1月~2015年9月我院诊治的肝硬化门静脉高压症患者80例和体检健康者75例,使用纤维内镜进行胃镜检查,判断食管胃底静脉曲张程度,使用意大利百胜Mylab60全数字化多普勒超声诊断仪测量门静脉内径、脾静脉内径、门静脉血流量和脾静脉血流量。结果肝硬化患者门静脉内径、脾静脉内径、门静脉血流量和脾静脉血流量分别为（1.4±0.6） cm、（1.2±0.3） cm、（1023.2±653.4） mL/min和（593.3±112.3） mL/min,均明显高于健康人【（0.9±0.2） cm、（0.6±0.4） cm、（916.3±254.2） mL/min和（325.6±96.4） mL/min,P<0.05】;46例门静脉内径≥1.4 cm组轻度曲张发生率为19.6%,明显低于34例门静脉内径<1.4 cm组的52.9%（P<0.05）,门静脉内径≥1.4 cm组重度曲张发生率为52.2%,明显高于门静脉内径<1.4 cm组的20.6%（P<0.05）;49例脾静脉内径≥1.0 cm组轻度曲张发生率为20.4%,明显低于31例脾静脉内径<1.0 cm组的51.6%（P<0.05）,脾静脉内径≥1.0 cm组重度曲张发生率为51.0%,明显高于脾静脉内径<1.0 cm组的22.6% （P<0.05）。结论超声检查诊断肝硬化门静脉高压症具有较高的敏感性和特异性,对食管胃底静脉曲张的轻重程度也具有良好的诊断价值,能为评价患者的肝功能和选择治疗方案提供重要的参考依据。

关键词: 肝硬化, 门静脉高压, 多普勒超声, 胃镜

Abstract: Objective To investigate the clinical application of ultrasonography in the diagnosis of patients with cirrhosis and portal hypertension. Methods 80 patients with liver cirrhosis and portal hypertension were recruited in our hospital between January 2008 and September 2015,and 75 healthy persons were included as control.The degree of esophageal-gastric varices was observed by endoscopy,and the portal vein diameters, splenic vein diameters,portal vein blood flow and splenic vein blood flow were determined by ultrasonography in the two groups. Results The diameter of portal vein was （1.4±0.6）cm,the diameter of splenic vein was （1.2±0.3）cm,the portal vein blood flow was （1023.2±653.4） mL/min,and the splenic vein blood flow was （593.3±112.3）mL/min in patients with cirrhosis,while the diameter of portal vein was（0.9±0.2）cm,the diameter of splenic vein was （0.6±0.4）cm,the portal vein blood flow was （916.3±254.2） mL/min,and the splenic vein blood flow was （325.6±96.4）mL/min in healthy persons （P<0.05）;the incidence of mild varices in 46 patients with portal vein diameter≥1.4cm was 19.6%,significantly lower than 52.9% in 34 patients with portal vein diameter <1.4cm（P<0.05）,and the incidence of severe varices in patients with portal vein diameter≥1.4cm was 52.2%,much higher than 20.6% in patients with portal vein diameter<1.4 cm（P<0.05）;the incidence of mild varies in 49 patients with splenic vein diameter≥1.0 cm was 20.4%,much lower than 51.6% in 31 patients with splenic vein diameter <1.0 cm（P<0.05）,and the incidence of severe varies in patients with splenic vein diameter ≥1.0 cm was 51.0%,much higher than 22.6% in patients with splenic vein diameter<1.0 cm（P<0.05）. Conclusion Ultrasound has high sensitivity and specificity in diagnosis of patients with liver cirrhosis and portal hypertension,which might provide a hint for the degree of esophageal-gastric varices and guide the options for clinical diagnosis and treatment.

Key words: Cirrhosis, Doppler ultras onography, Portal hypertension, Endoscopy

赵超占, 曾辉, 吴建军, 周利侠. 超声检查诊断肝硬化门静脉高压症临床价值研究[J]. 实用肝脏病杂志, 2016, 19(4): 455-458.

Zhao Chaozhan, Zeng Hui, Wu Jianjun, et al. Clinical application of ultrasonography in the diagnosis of patients with liver cirrhosis and portal hypertension[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2016, 19(4): 455-458.

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