计算机视觉食管曲张静脉压力检测技术的初步研究  

A new computerized endoscopic balloon manometry to detect esophageal variceal pressure： experimental validation and clinical feasibility

作　　者：孔德润[1] 张磊[1] 张超[2] 付忠谦[3] 郝加虎[4] 何兵兵[3] 孙斌[1] 谢岳[3] 李盼[1] 许建明[1] 

机构地区：[1]安徽医科大学第一附属医院消化科消化病重点实验室,合肥230022 [2]安徽医科大学第一附属医院肝胆外科,合肥230022 [3]中国科学技术大学电子科学与技术系 [4]安徽医科大学公共卫生学院

出　　处：《中华消化内镜杂志》2011年第4期204-209,共6页Chinese Journal of Digestive Endoscopy

基　　金：教育部高等学校博士点专项基金（20093420110006） 安徽省教育厅自然科学重点研究项目资助（KJ2010A158）

摘　　要：目的 在体内外实验中验证计算机视觉食管曲张静脉压力检测技术的可行性与可靠性.方法 采用计算机视觉食管曲张静脉压力检测技术,对仿真食管曲张静脉（直径3 mm,6 mm,8 mm）进行压力（压力范围在8～36 mm Hg）测量.比较计算机视觉食管曲张静脉压力检测技术检测仿真曲张静脉压力与实际压力值.另外,采用相同技术检测23例门脉高压患者食管曲张静脉压力,同时检测肝静脉压力梯度及其他与曲张静脉出血相关指标,并进行相关性分析.结果 体外实验发现,仿真曲张静脉的测压值与实际压力值具有良好相关性（r≥0.993,P＜0.001）,测压值偏差小（95%CI：-0.13 cm H2O～0.33 cm H2O）.临床研究23例患者食管曲张静脉压力检测均获得成功,可重复性好,变异系数小（r≥0.998）.食管曲张静脉压力与肝静脉压力梯度间具有良好的相关性（r=0.858,P＜0.001）,食管曲张静脉压力与既往出血史、血管直径及红色征相关,而与Child-Pugh分级无相关性（t=0.31,P=0.76）.结论 计算机视觉食管曲张静脉压力检测技术检测食管曲张静脉压力具有较好的可行性与可靠性.Objective To evaluate the clinical reliability and feasibility of computerized endoscopic balloon manometry in vitro and in vivo, in measurement of pressure of esophageal varices. Methods Computerized endoscopic balloon manometry was used to measure the pressure of variceal model with different diameter （3 mm, 6 mm and 8 mm） and intraluminal pressures （ranging from 8 to 36 mm Hg）, and the findings were compared with actual pressures. The technique was also applied in 23 patients with liver cirrhosis and esophageal varices, and its correlation with hepatic venous pressure gradient and other factors related with varices bleeding. Results The study in vitro showed that the measured intraluminal pressure was correlated significantly with the actual value （ r ≥ 0. 993, P 〈 0. 001 ） without obvious measurement bias（95% CI = -0.13 cm H2O to 0. 33 cm H2O）. The measurement in 23 patients were success with little variation coefficient （r≥0. 998） between repeated procedures. Regression analysis showed a good correlation between variceal pressure and hepatic venous pressure gradient （r=0. 858, P 〈 0. 001 ）. A higher variceal pressure was strongly associated with presence of previous bleeding episodes, vascular diameter and presence of red color signs, but did not correlate with the parameter of Child-Pugh classification （ t = 0. 31, P =0. 76）. Conclusion Computerized endoscopic balloon manometry is reliable and feasible to examine esophageal variceal pressure, and is very likely to be a valuable clinical index for variceal bleeding.

关 键 词：食管和胃静脉曲张 测压法 高血压 门静脉 

分 类 号：R575.2[医药卫生—消化系统]