彩色多普勒超声对伴有和不伴有附脐静脉开放的失代偿期肝硬化门静脉系统变化探讨

Comparison of hemodynamics of portal and splenic veins and spleens in decompensated cirrhotic patients with and without patent paraumbilical vein

目的比较伴有和不伴有附脐静脉开放的肝硬化门静脉高压症Child-Pugh C级患者的门静脉、脾静脉血流和脾脏变化特点。方法回顾性分析经临床诊断的乙型肝炎后肝硬化门静脉高压症失代偿期伴有附脐静脉开放和无附脐静脉开放的患者各30例;选择20例无肝脏疾病的健康检查者作为对照组。用彩色多普勒超声检测门静脉、脾静脉大小及其血流速度、脾脏大小,计算门静脉、脾静脉血流量。结果肝硬化门静脉高压症Child-Pugh C级患者的门静脉、脾静脉明显增宽,其血流速度明显减慢,脾脏显著增大;伴有和不伴有附脐静脉开放者之间的门静脉和脾静脉内径、流速、血流量和脾脏大小无显著性差别。结论肝炎肝硬化门静脉高压症Child-Pugh C级患者的门静脉和脾静脉内径、流速、血流量、脾脏大小在有和无附脐静脉开放者间无显著性不同。

【Objective】 To investigate the differences of hemodynamics of portal and splenic veins and sizes of spleens in Child-Pugh C cirrhotic patients with and without patent paraumbilical vein.【Methods】 Sixty patients with and without patent paraumbilical vein due to severe portal hypertension of liver cirrhosis of hepatitis B were studied retrospectively,patients with and without patent paraumbilical vein were 30 cases respectively and were assigned as group A and B correspondingly,and they were Child-Pugh C patients by classification;diameters,blood flow velocities,volumes of the portal,splenic and patent paraumbilical veins and sizes of the spleen were measured by color Doppler ultrasound and studied;20 healthy people were selected as control group.【Results】 Velocity and volume of the portal and splenic vein blood flow in the decompensated cirrhotic patients with and without patent paraumbilical vein decreased significantly,and diameters of portal and splenic veins and the sizes of spleen increased significantly,but there were no significant differences between the patients with and without patent paraumbilical vein for them;while the differences between the control group and group A and group B were significant.【Conclusion】 The hemodynamics of portal and splenic veins and sizes of spleens in Child-Pugh C cirrhotic patients with and without patent paraumbilical vein have no significant difference.