肝硬化门静脉系统血流动力学变化与食管静脉曲张出血的关系

Relationship between Changes of Portal Hemodynamics and Esophageal Varicosity Bleeding in Patients with Liver Cirrhosis

目的探讨肝硬化患者门静脉系统血流动力学变化与食管静脉曲张破裂出血的关系。方法运用彩色多普勒超声仪检测86例肝硬化门脉高压伴食管静脉曲张患者的门静脉和脾静脉的最大截面直径、平均血流速度,计算血流量(F)和淤血指数(CI)。结果肝功能Child-PughC级患者门静脉的最大截面直径(PVD)、血流速度(PVV)和淤血指数(PVCI)与A级、B级患者相比,差别有显著性意义(P<0.05)。食管静脉曲张破裂出血(EVB)患者的PVD、PVV、PVCI、脾静脉淤血指数(SVCI)、脾静脉血流速度(SVV)与无EVB患者相比,差别有显著性意义(P<0.05)。结论肝硬化门脉高压患者门脉系统血流动力学改变受肝功能损害程度影响,且与食管静脉曲张破裂出血相关。

Objective To investigate the relationships between the changes of portal hemodynamics and esophageal varicosity bleeding in patients with liver cirrhosis. Methods The portal systemic hemodynamical parameters in 86 cirrhotic patients with esophageal varicosity were detected by Doppler uhrasonography, including the max diameters, mean flow velocity, flow rate and congestion index （CI） of the portal vein trunks （PV） and splenic veins （SV）, Results There were significant differences in the PV diameters （PVD）, PV flow velocity （PVV） and PV congestion index （PVCI） between the patients with hepatic function in Child -pugh C and those in Child -pugh A and B （ P 〈 0. 05 ）, There were significant differences in PVD, PVCI, SV congestion index （SVCI） and SV flow velocity （SVV） between patients with esophageal varicosity bleeding （EVD） group and those with no EVD （ P 〈 0. 05 ）, Conclusion The changes of portal hemodynamics in cirrhotic patients with portal hypertension are related with damage degree of hepatic function and correlated to EVB