彩色多普勒超声检测门静脉、脾静脉血流动力学在肝硬化食管胃底静脉曲张患者中的临床应用研究  

Clinical application of color Doppler ultrasonography in detecting porlal vein and splenic vein hemodynamics in patients with liver errhosis and esophageal and gastric varices

作　　者：刘水澎 张国顺 LIU Shui peng;ZHANG Guo shun(Department of Ultra-sound,Affiliated Hospital of North China University of Science and Techrology,Tangshan 063000,China;De partment of Gustroenterology,Affiliated Hospital of North China University of Science and Techrology,Tangshan 063000,China)

机构地区：[1]华北理工大学附属医院超声科,河北唐山063000 [2]华北理工大学附属医院消化内科,河北唐山063000

出　　处：《中国实验诊断学》2023年第4期436-439,共4页Chinese Journal of Laboratory Diagnosis

基　　金：中国肝炎防治基金会资助项目(TQGB20170015);河北省医学科学研究重点课题计划项目(20170933,20210375);河北省科技厅资助项目(162777133);华北理工大学研究生创新项目(2019S49,2019B30)。

摘　　要：目的探讨彩色多普勒超声检测门静脉、脾静脉血流动力学在肝硬化食管胃底静脉曲张患者中的临床应用价值。方法选取2018年1月-2021年12月于华北理工大学附属医院住院的肝硬化伴食管胃底静脉曲张患者88例为病例组。选择同期住院的肝硬化不伴有食管胃底静脉曲张患者102例为对照组。观察两组患者门静脉、脾静脉血流动力学变化情况。结果病例组在总横断面表面积、胃左静脉直径、肠系膜上静脉直径高于对照组,在曲张静脉壁厚度低于对照组,差异均有统计学意义(P<0.05)。病例组检测门静脉主干内径(PVD)、门静脉血流量(PVQ)、脾静脉主干内径(SVD)、脾静脉血流量(SVQ)均显著高于对照组,门静脉平均血流速度、脾静脉平均血流速度显著低于对照组,差异均有统计学意义(P<0.05)。重度曲张患者PVD、PVQ、SVD、SVQ显著高于中度和轻度曲张患者,门静脉平均血流速度、脾静脉平均血流速度显著低于中度和轻度曲张患者,随着曲张程度加重,PVD、PVQ、SVD、SVQ逐渐增加,门静脉平均血流速度、脾静脉平均血流速度逐渐降低,差异均有统计学意义(P<0.05)。结论门静脉、脾静脉血流动力学与肝硬化伴食管胃底静脉曲张患者关系密切,测量肝硬化患者门静脉、脾静脉血流动力学有助于预测食管胃底静脉曲张破裂出血发生的风险。胃左静脉离肝血流提示肝硬化患者存在食管胃底静脉曲张的风险较大。Objective To explore the clinical application of color Doppler ultrasound in detecting portal vein and splenic vein hemodynamics in patients with liver cirrhosis esophageal and gastric varices.Methods A total of 88 patients with liver cirrhosis and esophageal and gastric varices who were hospitalized in the Affiliated Hospital of North China University of Science and Technology from January 2018 to December 2021 were selected as the case group.102 patients with liver cirrhosis without esophageal and gastric varices who were hospitalized during the same period were selected as the control group.The hemodynamic changes of portal vein and splenic vein were observed in the two groups.Results The total cross-sectional surface area,left gastric vein diameter,and superior mesenteric vein diameter in the case group were higher than those in the control group,and the thickness of the varicose vein wall was lower than that in the control group,and the differences were statistically significant(P<O.05).The portal vein diameter(PVD),portal vein blood flow(PVQ),splenic vein main diameter(SVD),and splenic vein blood flow(SVQ)in the case group were significantly higher than those in the control group.The portal vein average mean blood flow velocity and splenic vein average mean blood flow velocity were significantly lower than that of the control group,and the difference was statistically significant(P<0.05).The PVD,PVQ,SVD and SVQ in patients with severe varicose were significantly higher than those in patients with moderate and mild varicose,Portal vein average mean blood flow velocity and spleen vein average mean blood flow velocity were significantly lower than those in patients with moderate and mild varicose.With the aggravation of varicose degree,PVD,PVQ,SVD and SVQ gradually increased,Portal vein average mean blood flow velocity and spleen vein average mean blood flow velocity decreased gradually,and the difference was statistically significant(P<0.05).Conclusion Portal vein and splenic vein hemodynamics are closely rel

关 键 词：彩色多普勒超声 肝硬化 食管胃底静脉曲张 门静脉血流动力学 

分 类 号：R455.1[医药卫生—运动医学]