彩色多普勒超声对门静脉高压食道胃底静脉曲张破裂出血的判断  

Assessment on the risk of bleeding in patients with esophageal varices by color Doppler sonography

作　　者：刘长珠[1] 傅小敏[1] 黄君[1] 

机构地区：[1]暨南大学第一附属医院超声科,广东广州510630

出　　处：《医师进修杂志》2004年第3期13-15,共3页Journal of Postgraduates of Medicine

基　　金：广东省卫生厅资助 (A2 0 0 13 3 2 )

摘　　要：目的　探讨应用彩色多普勒超声对门静脉高压食道胃底静脉曲张破裂出血的判断价值。方法　根据门静脉高压食道胃底静脉曲张患者有无出血分为出血组 (2 5例 )、未出血组 (2 5例 )与健康对照组 (15例 )进行对比分析。结果　出血组、未出血组与健康对照组门脉充血分数分别为 :0 .12 6± 0 .0 5 6、0 .0 6 0± 0 .0 2 0、0 .0 34± 0 .0 15 ,出血组与未出血组比较有显著差异 (P <0 .0 0 1) ;胃左静脉内径分别为 :(0 .89± 0 .2 6 )cm、(0 .70± 0 .2 4 )cm、(0 .31± 0 .0 7)cm ,出血组与未出血组比较有显著差异 (P <0 .0 5 ) ;出血组与未出血组食道曲张静脉内径分别为 :(0 .4 9± 0 .12 )cm、(0 .34± 0 .11)cm ,两者比较有显著差异 (P <0 .0 1) ;食道曲张静脉内血流速度分别为 (17.9± 7.4 )cm s、(11.1± 6 .0 )cm s,两者比较有显著差异 (P <0 .0 1)。当门脉充血分数截定为 0 .0 7时 ,对出血预测敏感性 96 % ,特异性 76 %。结论　门脉充血分数、胃左静脉内径、食道曲张静脉内径及其血流速度对判断出血具有重要作用。Objective To assess risks of esophageal variceal bleeding in patients with portal hypertension by using color Doppler sonography. Methods 25 esophageal variceal patients with previous hemorrhage,and 25 esophageal variceal patients without previous hemorrhage and 15 controls were compared as for using color Doppler sonography. Results The congestion index in patients with previous hemorrhage ,patients without previous hemorrhage and controls were 0.126±0.056,0.060±0.020,0.034± 0.015 .A comparison of the congestion index in patients with previous hemorrhage and in patients without previous hemorrhage was statistical difference (P <0.001).The inside diameter of left gastric vein in patients with previous hemorrhage ,patients without previous hemorrhage and controls were (0.89±0.26)cm,(0.70±0.24)cm,(0.31±0.07)cm. A comparison of the inside diameter of left gastric vein in patients with previous hemorrhage ,patients without previous hemorrhage was statistical difference (P < 0.05 ). The inside diameter of variceal vein in patients with previous hemorrhage ,patients without previous hemorrhage were (0.49±0.12)cm,(0.34±0.11)cm.A comparison of the inside diameter of variceal vein in patients with previous hemorrhage ,patients without previous hemorrhage was statistical difference (P <0.01),the blood flow velocity of variceal vein in patients with previous hemorrhage ,patients without previous hemorrhage were (17.9±7.4)cm/s,(11.1±6.0)cm/s. A comparison of the blood flow velocity of variceal vein in patients with previous hemorrhage ,patients without previous hemorrhage is statistical difference (P <0.01).When the congestion index was 0.07,the sensitivity and specificity in predict bleeding were 96% and 76%.Conclusion The congestion index,the diameter of left gastric vein and variceal ,the blood flow volocity of variceal are sensitive and specific in predicting esophageal variceal bleeding.

关 键 词：彩色多普勒超声 门脉高压 食道胃底静脉曲张破裂出血 

分 类 号：R571.1[医药卫生—消化系统]