超声对急性、亚急性重症肝炎的诊断价值

Ultrasonic characteristics of acute severe and subacute hepatitis

目的 探讨急性、亚急性重症肝炎的声像图表现其临床意义。方法 应用超声诊断技术,观察了66例肝穿刺病检或死后尸解证实的急性、亚急性重症肝炎的超声声像图,并作一回顾性分析总结,与10 0例急性黄疸型肝炎和10 0例慢性活动型肝炎作对照比较。常规超声探测肝、胆、脾、腹水等项目。结果 ①急性、亚急性重症肝炎肝脏的动态观察,肝脏各径线值减小,腹水持续存在提示预后不良。②急性、亚急性重症肝炎呈现肝弥漫性病变,肝表面欠光滑,脾稍增大,门脉增宽与普通急肝有显著性差异(P <0 .0 5 ) ;其肝脏形态未失常,胆囊缩小壁厚与慢性肝损害,有显著性差异(P <0 .0 1)。③门脉流速减低,有腹水与普通肝炎差异有显著性意义(P <0 .0 1)。结论 超声检查对重肝的早期诊断及动态观察,有重要的临床参考意义。

Objective To explore the ultrasound characteristics of acute severe hepatitis(ASH) and sub-acute severe hepatitis(SSH).Methods 66 cases of ASH and SSH confirmed by autopsy and liver biopsy were included and undergone ultrasonography. The specific findings were reviewed retrospectively and a comparative analysis was made between 100 cases of acute hepatitis and 100 cases of chronic hepatitis.Results ① Dynamic scan indicated that the continuous liver shrinking and the persistent ascites mean poor prognosis. ②The ultrasound imagines of ASH and SSH were not well distributed on liver and showed the surface of liver was not smooth the spleen was a little big. These showed significantly higher than those of acute hepatitis (P<0.05); The ultrasound imagines of ASH and SSH showed the shape of liver was normal and the gallbladder got smaller and the wall of gallbladder got thick. These showed significantly higher than those of chronic hepatitis (P<0.01).③Acute portal vein hypertension and the ascites showed significantly higher than those in the control (P<0.01).Conclusion Ultrasound is helpful in early diagnosis of ASH and SSH.