彩色多普勒超声对肝硬化上消化道出血门静脉血流动力学改变的诊断价值

Diagnostic value of color doppler ultrasound on portal hemodynamics of gastrointestinal bleeding in cirrhosis of the liver

目的探讨彩色多普勒超声在肝硬化上消化道出血门静脉血流动力学改变中的诊断价值。方法选择2010年6月至2012年11月收治的肝硬化门静脉高压患者60例，根据是否合并上消化道出血分为无出血组33例、出血组27例，另外再选择35例健康体检者为对照组，三组患者均采用彩色多普勒超声测定其门静脉血流量情况。结果60例肝硬化患者的门静脉内径及血流量、胃左静脉内径及分流指数、脾静脉内径及血流量等六项指标明显高于正常对照组，且肝硬化上消化道出血患者的六项指标高于无出血组，差异有统计学意义（P〈0．05）。肝硬化患者门静脉及脾静脉的血流速度均低于对照组，出血组血流速度低于无出血组，差异有统计学意义（P〈0．05）。结论可以根据彩色多普勒超声分析门静脉血流量变化来预测肝硬化上消化道出血情况，具有重要临床实用价值。

Objective To investigate the diagnostic value of color doppler ultrasound on portal hemodynamics of gastrointestinal bleeding in cirrhosis of the liver. Methods From June 2010 to November 2012, sixty cases of cirrhosis and portal hypertension in our hospital were selected as study group. Depending on whether the merger of upper gastrointestinal bleeding, they were divided into without bleeding group （33 cases ） and hemorrhage group （27 cases ） , while 35 healthy cases in our hospital were selected as healthy control group, the portal blood flow of three groups were measured u- sing color Doppler ultrasound. Results Sixty patients with cirrhosis and portal vein blood flow velocity, left gastric vein diameter and shunt index, splenic vein diameter and blood flow velocity was significantly higher than the normal six indica- tors in the control group, and the upper gastrointestinal bleeding in patients with cirrhosis of the six index were higher than patients without bleeding（ P 〈 0.05 ）. Cirrhosis and portal vein blood flow velocity in patients with splenic vein were lower than the normal control group, the blood flow velocity was lower than that in the group without bleeding（ P 〈 0.05 ）. Conclusions According to the analysis of color Doppler ultrasound to predict changes in portal blood flow gastrointestinal bleeding cirrhosis has important clinical value.