肝硬化患者门脉血流的评价

Evaluation of Hemodynamic Changes of Portal Veins in Patients with Liver Cirrhosis by Color Doppler

目的探讨彩色多普勒超声对肝硬化门脉系统的血流动力学改变对临床诊断的指导意义。方法用彩色多普勒超声对正常对照组(20例),代偿期肝硬化组(22例)和失代偿期肝硬化组(8例)患者门静脉内径、门静脉横截面积和血流速度分别进行检测。结果代偿期肝硬化组、失代偿期肝硬化组组间的门静脉主干内径、门脉截面积、门脉充血指数是逐渐增加的,与对照组比较有显著性差异;对照组、代偿期肝硬化组、失代偿期肝硬化组组间的门脉血流速度是逐渐减少的,与对照组比较有显著性差异;对照组、失代偿期肝硬化组组间以及代偿期肝硬化组、失代偿期肝硬化组组间的门脉血流量是下降的,与对照组比较有显著性差异;失代偿期肝硬化并食管胃底静脉曲张、脾肿大肝硬化组门静脉与脾静脉血流速度、血流量两组比较有显著性差异。结论门静脉血流动力学变化参数,对肝硬化门静脉高压的诊断和治疗有一定的临床意义。

Objective To explore hemodynamic changes of liver portal veins in patients with liver cirrhosis. Methods Internal diameter （mm）, cross section area（cm^2） and blood flow velocity（cm/s） of the portal vein were detected by color doppler separately in 20 cases（control group）, 22 cases with compensated liver cirrhosis（compensated group ） and 8 cases decompensated liver cirrhosis（ decompensated group）. Results The internal diameter, cross section area and congestive index of liver portal vein increased, blood flow velocity and blood flow volume of liver portal vein decreased gradually from control group, compensated group to decompensated group, and there was significant difference among groups; The blood flow velocity and volume of spleen vein were higher than those of portal vein in the decompensated group with varices of esophagus and spleen, and difference was significant. Conclusion Color doppler is used to evaluate liver hemodynamics quantitatively as a convenient and non-invasive method in the diagnosis, development, treatment and prognosis of portal vein hypertension, by which some hemodynamics parameters of portal vein can be acquired, and the occurrence rate of varices of esophagus and the possibility of rupture and bleeding of varices in liver portal vein hypertension are predicted.