多层螺旋CT门静脉成像评价脾肾静脉分流的价值  

The value of multi-slice spiral CT in portal vein imaging for evaluating splenorenal shunt

作　　者：张灿环 刘鸿雁[1] 张炳[1] 高健[1] 王国华[1] 方明[1] 王钦习[1] ZHANG Can-huan;LIU Hong-yan;ZHANG Bing;GAO Jian;WANG Guo-hua;FANG Ming;WANG Qin-xi(Department of Radioligy, Qingdao Municipal Hospital Affiliated to Qingdao University, Qingdao Shandong 266011, China)

机构地区：[1]青岛大学附属青岛市市立医院放射科,山东青岛266011

出　　处：《中国临床医学影像杂志》2018年第4期277-280,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:通过128层螺旋CT门静脉成像研究脾肾静脉分流的有无,评价脾肾静脉分流在临床诊断及治疗方面的应用价值。方法:对2014年12月—2016年1月收治的146例肝硬化患者根据脾/胃-肾分流的有无将所筛选患者分成A、B两组,比较两组门静脉、脾静脉、左肾静脉管径平均值和食管下段静脉曲张发生率及严重程度有无差别。结果:A组即有脾肾静脉分流患者为40人,B组即无脾肾分流患者为106人,脾肾静脉分流的发生率约为27.4%;两组患者食管下段静脉曲张严重程度的差异具有统计学意义(χ~2=6.24>χ~2_(0.05,2)=5.99,P<0.05);门脉高压食管静脉曲张的严重程度与脾肾分流的有无呈显著相关性(P=0.01<0.05)。结论:脾肾静脉分流能降低食管胃底静脉曲张的发生率,缓解其严重程度,在门静脉高压行分流术时可以利用已存在的脾肾静脉分流道,达到降低门静脉压力的目的。Objective： To evaluate the application value of splenorenal shunt in clinical diagnosis and treatment through portal vein imaging by 128 slice spiral CT. Methods： According to the presence of splenic/gastric-renal shunt, 146 patients with liver cirrhosis from December 2014 to January 2016 were divided into two groups： group A and group B. Average diam- eters of the portal vein, the splenic vein and the left renal vein, and the incidence and severity of esophageal varices in two groups were compared. Results： Forty patients in A, and 106 patients in B. The incidence of splenorenal shunt was about 27.4%. The difference between the two groups in the severity of esophageal varices was statistically significant（x2=6.24〉x^2 0.05. 2= 5.99, P〈0.05）. The severity of esophageal varices was significantly correlated with splenorenal shunt（P=-0.01〈0.05）. Conclusion： The splenorenal shunt can reduce the incidence and relieve the severity of esophageal varices. In the operation of portal hy- pertension, the existing splenorenal shunt can be used to reduce the pressure of the portal vein.

关 键 词：肝硬化 肾静脉 脾静脉 体层摄影术 X线计算机 血管造影术 

分 类 号：R575.2[医药卫生—消化系统] R814.41[医药卫生—内科学]