超声检查在肝硬化患者经颈静脉肝内门静脉内支架分流术后的应用

Ultrasonic examination for patients with liver cirrhosis after transjugular intrahepatic portosystemic shunt

目的探讨超声检查在肝硬化患者经颈静脉肝内门静脉内支架分流(TIPS)术后肝内门静脉与下腔静脉之间人工通道内支架(SIAC)及门静脉(PV)的应用效果。方法回顾性分析2013年1月至2017年2月28例因肝硬化前来我院接受TIPS患者的临床资料,使用腹部凸阵探头扫查肝硬化患者TIPS术后分流通道内支架和门静脉并测量其内径,然后利用多普勒超声观察分流通道内支架及门静脉的血流,并测量血流速度。结果肝硬化患者TIPS术后分流通道内支架呈平行管状高回声,管壁光整,管腔清晰,管腔内径为(5.93±0.76)mm,管腔血流速度(97.14±28.46)cm/s;其95%参考值分别为4.45~7.41 mm和41.36~152.92 cm/s。门静脉管腔内径为(12.40±2.90)mm,血流速度为(38.33±16.01)cm/s;其95%参考值分别为6.72~18.08 mm和22.32~49.34 cm/s。结论超声检查能对TIPS术后的分流通道内支架及门静脉狭窄与否做出客观评价,并获得了二者的测量参数,是疗效随访观察较理想的方法。

Objective To investigate the application of ultrasonic examination for patients with liver cirrhosis after transjugular intrahe- patic portosystemic shunt （TIPS） in the stents in artificial channel （SIAC） and portal vein （PV）. Methods The clinical data of 28 patients who were admitted into our hospital from January 2013 to February 2017 and received TIPS were analyzed. Scanned the stents in artificial channel and portal vein and their inner diameter through transabdominal probe, and then measured the blood flow velocity by doppler. Results After TIPS, the SIAC of cirrhosis patients showed parallel tubular high echo, smooth wall and clear vessel lumen. And the inner diameter of SI- AC was （5.93 ± 0.76）mm,the blood flow velocity was （97.14±28.46）cm/s, and the 95% reference value was 4.45 mm -7.41 mm and 41.36 - 152.92 cm/s respectively. And the inner diameter of PV was （ 12.40 mm ＋ 2.90） mm, the blood flow velocity was （ 38.33 cm -＋ 16. O1 ） cm/s, and the 95% reference value was 6.72 - 18.08 mm and 22.32 ± 49.34 cm/s respectively. Conclusion Ultrasonography can give objective evaluation of whether SIAC and PV is unobstructed after TIPS, and it can get their parameters of inner diameter and velocity. As a result, ultrasonography can be regard as a perfect means for follow-up checkup.