彩色多普勒超声预测食管静脉曲张破裂出血风险的价值

Value of colored doppler forecast the esophagus varicosity hemorrhage risk

目的通过彩色多普勒超声测定胃左静脉与门静脉直径、血流速度、血流量、血流方向等血流动力学指标,探讨其预测食管静脉曲张程度与出血风险的价值。方法肝硬化门静脉高压症患者86例,均接受彩色多普勒超声、电子胃镜及肝炎标志物、肝功能等常规/检查。以研究对象在24个月随访期内有出血史且经内镜检查确定为食道胃底静脉曲张破裂出血为出血风险的评价标准。对比分析出血组与非出血组的胃左静脉、门静脉血流动力学特点。结果胃左静脉的离肝血流方向在出血组与非出血组间差异有统计学意义(χ2=12.049,P=0.00),这种显著性差异在Child分级的三级肝功能状态下均存在。不同肝功能状态下门静脉的离肝血流方向在出血组与非出血组间差异无统计学意义P>0.05。以胃左静脉内径6mm、门静脉内径16mm为预测食管静脉曲张出血风险分层指标,出血患者中门静脉内径≥16mm与非出血组比较差异有统计学意义(χ2=4.21,P=0.04)。结论彩色多普勒超声测定胃左静脉血流方向、门静脉内径预测食管静脉曲张出血风险具有应用价值。

Objective To determine left gastric vein （LGV） and portal vein （PV） blood flow dynamics vein diameter, blood flow speed, blood flow quantity, blood flow direction through colored Doppler,discuss its evaluation of LGV and PV blood flow dynamics predicting esophageal variceal bleeding in patient with liver cirrhosis complicated portal hypertension. Methods 86 liver cirrhosis complicated portal hypertension patients accepted examinations including colored Doppler endoscope, hepatia and so on. Contrasted analysis hemorrhage group and non-hemorrhage group＇ s LGV and PV blood flow dynamics characteristic. Results The LGV had remarkable difference to the liver blood stream direction in the hemorrhage group with the non-hemorrhage group （X^2 = 12. 049,P = 0.00） , this kind of remarkable difference existed in under the Child graduation three levels of liver function condition, took LGV inside diameter 6 mm, PV inside diameter 16 mm as forecast the esophagus varicosity hemorrhage risk lamination target,the homorrhage group PV inside diameter ≥ 16 mm to compare the existence remarkable difference with the non-hemorrhage group （X^2 = 4. 21, P = 0. 04 ）. Conclusion Colored Doppler determines LGV blood stream direction,PV the inside diameter forecast the esophagus varicosity hemorrhage risk has the application value.