预测及处理肝硬化食管曲张静脉出血的临床应用研究  

The Clinical Research on Risk Predict and Treatment of Esophageal Varices Bleeding in Patients with Liver Cirrhosis

作　　者：田蕾[1,2] 夏冰[1,2] 

机构地区：[1]武汉大学中南医院 [2]武汉市第十一医院,湖北武汉430015

出　　处：《河北医学》2014年第3期400-402,共3页Hebei Medicine

摘　　要：目的:对肝硬化食管曲张静脉出血(EVB)的相关因素分析,提出合理有效的预测及处理方式。方法:选取本院自2011年以来因肝硬化入院的患者80例,根据患者出血的情况将患者分为出血组48例和未出现组32例。对两组患者进行内镜和腹部超声检查,测量门静脉系统内径以及血流动力学参数,对比两组检查结果,分析可能引发出血的因素,并对出血组患者采取内径下曲张静脉套扎治疗和注射硬化剂进行治疗。结果:出血组患者的静脉曲张红色征出现率与未出血组相比更高;出血组患者门静脉、脾静脉和胃左静脉的内径较未出血组显著增加;出血组患者的门静脉和脾静脉最大血流速度较未出血组更低。结论:内镜结合超声检查可以对EVB进行预测,红色征、门静脉、脾静脉和胃左静脉的内径增加以及门静脉和脾静脉最大血流速度是预测依据,对往后临床预测EVB有一定的借鉴意义。Objective：To analyse the risk factors of esophageal varices bleeding in patients with liver cirrhosis, and to put forward reasonable and effective way to predict and treatment for the disease .Method：80 patients with liver cirrhosis in our hospital since 2011 , according to bleeding in patients ,They were divid-ed into two groups , 48 patients in bleeding group and the other 32 patients in non-bleeding group .Two groups of patients were tested for endoscopy and abdominal ultrasound , measure portal vein diameter and he-modynamic parameters , then compared test results of two groups , and then analyzed the factors that may lead to bleeding.Patients in bleeding group were treated with variceal ligation and injection sclerotherapy .Result：The variceal red signs appeared rate was higher in bleeding group compare with non-bleeding group, Portal, splenic vein and left gastric vein diameter was significantly increased in bleeding group compare with non -bleeding group , the portal and splenic vein maximum flow was lower in bleeding group than in non-bleeding group.Conclusion：Endoscopic combined with ultrasonography can predict EVB , red sign and increased di-ameter of portal vein , splenic vein and left gastric vein ,as well as increased maximum flow velocity in portal vein and splenic vein can be used as a basis for prediction ,has a certain significance for subsequent clinical prediction of EVB .

关 键 词：肝硬化 食管曲张静脉出血 预测 

分 类 号：R575.2[医药卫生—消化系统]