彩色多普勒超声对肝硬化门、脾静脉血流动力学检测的临床意义

Clinical significance of color Doppler ultrasound in the detection of hepatic cirrhosis and splenic venous hemodynamics

目的：探讨彩色多普勒超声对肝硬化患者门、脾静脉血流动力学临床意义。方法：选取2014年8月～2015年8月于我院诊治的60例肝硬化患者为肝硬化组，按肝功能Child—Pauh分级标准分为A、B、c级，设健康体检者为健康组对比研究，采用彩色多普勒超声仪分别测量门静脉内径（DPV）、血流速度（VPV）、血流量（QPV）及脾静脉内径（DSV）、血流速度（VSV）、血流量（QSV），并计算DSV／DPV。结果：肝硬化组DPV、QPV、DSV、QSV较健康组显著升高，VPV、VSV较健康组显著降低，差异有统计学意义（P〈0．05）；DSV／DPV值肝硬化组较健康组升高，差异有统计学意义（P〈0．05）。随着Child—Pauh分级A、B、C级的升高，DPV、DSV逐渐增宽，VPV、VSV逐渐减慢，QSV逐渐增多，DSV／DPV逐渐升高，各级间比较，差异有统计学意义（P〈0．05）；而QPV增多不明显，差异无统计学意义（P〉0．05）。结论：彩色多普勒超声对门静脉系统血流动力学检测具有简便、无创、可反复操作等优点，对肝硬化患者肝功能评估有重要意义。

Objective.. To investigate the clinical significance of color Doppler ultrasound in the diagnosis of liver cirrho- sis patients with portal and splenic venous hemodynamics. Methods： A total of 60 liver cirrhosis patients were selected in our hospital from August 2014 to August 2015 and were graded into A, B, C according to the standard of liver function in Child- Pauh. Healthy group was set for comparative study. Use of color Doppler ultrasound in portal vein diameter （DPV）, blood flow velocity （VPV）, blood flow （QPV） and splenic vein （DSV）, blood flow velocity （VSV）, blood flow （QSV） were meas- ured, and DSV/DPV was calculated. Results.. DPV, DSV, QPV, QSV in liver cirrhosis group were significantly higher than those in the healthy group, VSV and VPV were significantly lower than those in the healthy group （P〈0.05）, and the DSV/ DPV values in liver cirrhosis group were significantly higher than those in the healthy group （P〈0.05）. With the increased level from Child-Pauh grade A, B to C, DSV and DPV gradually increased, VSV and VPV gradually decreased, QSV increased gradually, DSV/DPV gradually increased, the difference was statistically significant （P〈0.05）, while QPV was not obvious, no significant difference （P〉0.05）. Conclusions.. Color Doppler ultrasound in portal vein hemodynamics detection is simple, noninvasive and repeatable, which has great significance in the evaluation of liver function in liver cirrhosis patients.