多普勒超声检测肝硬化门静脉和脾静脉血流量的临床意义  

Clinical Significance of Doppler Ultrasonography Measurement of Portal Venous and Splenic Venous Flows in Patients with Liver Cirrhosis

作　　者：王燕[1,2] 李涛[1,2] 要金芳[1,2] 秦玉玲 王金爱[1,2] 刘明瑜 

机构地区：[1]石家庄市河北医科大学第二医院功能科 [2]河北医科大学第四医院超声科

出　　处：《中国超声医学杂志》1999年第5期370-372,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的：本研究旨在探讨多普勒超声检测脾静脉血流量大于门静脉血流量与肝硬化门静脉系统食管胃底静脉曲张及其破裂出血的关系。方法：对５８例肝硬化患者门脉系统血流进行彩色多普勒血流检测，其中３０例患者脾静脉血流量大于门静脉血流量（即ＱＳＶ＞ＱＰＶ），２８例患者门静脉血流量大于脾静脉血流量（即ＱＰＶ＞ＱＳＶ），所有患者均在三个月内同时或先后进行电子胃镜及上消化道造影检查，确定食管胃底静脉曲张或破裂出血的发生率。结果：ＱＳＶ＞ＱＰＶ组的脾静脉血流量、脾静脉直径、脾脏厚度均大于ＱＰＶ＞ＱＳＶ组的测值，而其门静脉直径及血流量均小于ＱＰＶ＞ＱＳＶ组的测值。经电子胃镜及上消化道造影检查证实，ＱＳＶ＞ＱＰＶ组患者食管胃底静脉曲张发生率及曲张静脉破裂出血率均较ＱＰＶ＞ＱＳＶ组明显增高。结论：脾静脉血流量超过门静脉血流量与食管胃底静脉曲张及其破裂出血有密切关系。一旦多普勒超声检测出现脾静脉血流量高于门静脉血流量这一血流动力学改变，则预示肝硬化患者多有门－体侧支循环开放，即静脉曲张，并有破裂出血倾向。Objective:To determine if the Doppler sonographic finding of splenic vein flow exceeds the portal vein flow in liver cirrhosis associated with portosystemic varices.Methods:Fifty eight liver cirhosis patients were studied with Doppler US retrospectively.Results:30 patients splenic venous flow exceeded portal venous flow(Q SV >Q PV group),28 patients portal venous flow exceeded splenic venous flow(Q PV >Q SV group).All patients were also picked out with electron endoscopy and gastrointestinal radiography(GI)within 3 months to be determined the prevalence of varices and variceal hemorrhage.The flow in the splenic vein was significantly higher and the flow in the portal vein was significantly lower in the Q SV >Q PV group than in the Q PV >Q SV group.The diameter of the portal vein was significantly smaller and the diameter of the splenic vein was significantly larger in the Q SV >Q PV group than in the Q PV >Q SV group.Mean splenic size was significantly larger in the Q SV >Q PV group than in the Q PV >Q SV group.Furthermore,the prevalence of varices and variceal hemorrhage as determined by gastrointestinal radiography and electron endoscopy was higher in the Q SV >Q PV group than in the Q PV >Q SV group.Conclusion:Doppler sonographic finding of splenic venous flow exceeding portal venous flow is associated with a higher prevalence of portosystemic varices.When this unique flow pattern is observed,the patients with liver cirrhosis probably have a higher prevalence of varices in the esophageal and coronary regions,which tend to be more likely to bleed.

关 键 词：多普勒超声 肝硬化 门静脉血流 脾静脉血流 

分 类 号：R575.204[医药卫生—消化系统] R445.1[医药卫生—内科学]