三氯乙烯药疹样皮炎患者肝损害的B超影像学研究

Research on ultrasonography for hepatic dysfunction patients with trichloroethylene medicamentose-like dermatitis

目的探讨三氯乙烯药疹样皮炎患者肝损害的B超影像学特征和临床意义。方法使用美国通用LOGIQ7型彩色多普勒超声显像仪,对住我院的三氯乙烯药疹样皮炎患者50例(男31例,女19例)进行肝胆脾B超影像学观察。同时测定其肝功能指标。选择同期来我院上岗前体检者,与病例性别、年龄配对,排除有肝脏疾病史和接触过肝毒性物质者50例(男30例,女20例)作为对照组。结果三氯乙烯药疹样皮炎患者入院时肝脾大小测值大于出院时,差异有显著性(P<0.01,P<0.05);肝脏肿大者肝功能指标高度升高发生率高于肝脏大小正常者,差异有显著性(P<0.05);随着病情好转,门静脉血流量也增加,病情加重,门静脉血流量减低,门静脉血流量出院时大于入院时,差异有显著性(P<0.05)。患者临床治愈出院,肝脾大小测值大多数恢复正常。结论三氯乙烯药疹样皮炎患者大多伴发严重的肝损害,其肝胆脾B超影像学具有一定特征,特别是门静脉血流量,可以作为指标之一,为三氯乙烯肝损害的诊断治疗提供帮助和依据,有一定的临床实用价值。

Objective To explore the characteristics and clinical significance of ultrasonography for hepatic dysfunction patients with trichloroethylene （TCE） medicamentose-like dermatitis. Me,otis 50 patients （31 men and 19 women） with TCE medicamentose-like dermatitis in our hospital were observed by color Doppler ultrasonic instrument （General LOGIQ7）. The indexes of liver function were observed at the same time. 50 persons （30 men and 20 women） without liver and viscera diseases and without liver affected toxicant exposure who had their body checked-up before employment were selected as the control. Resuits The sizes of liver and spleen of patients with TCE medicamentose-like dermatitis before treatment were bigger than those after treatment, showing significant difference （ P 〈0, 01 ）. The occurrence ratio of enhancement of liver function indexes in patients was higher than that in those with normal livers （P 〈 0. 05）. Portal vein blood flow increased with the improvement of the disease while decreased with the aggravation of the disease. Portal vein blood flow after treatment was higher than that before treatment （P 〈 0. 05）. The sizes of liver and spleen of the patients became normal when they clinically recovered. Conclusion The occurrence ratio of hepatic dysfunction with TCE medicamentose-like dermatitis was high and severe. Ultrasonography of abdomen especially portal vein blood flow reveales their characteristics. Portal vein blood flow can be used as one of the indexes of liver function. Ultrasonography provides evidences for diagnosis and therapy of TCE medicamentose-like dermatitis.