肝硬化食管静脉曲张大出血患者门脉血流动力学检测及其临床意义

Clinical significance of portal vein hemodynamics measuremens in patients with cirrhosis and esophageal variceal bleeding

目的 探讨肝硬化食管静脉曲张破裂大出血患者门静脉血流动力学状态并分析其与Child—Pugh肝功能分级的关系。方法 运用彩色多普勒技术检测 3 1例肝硬化食管静脉曲张破裂大出血患者门脉血流动力学状态 ,测定门静脉的血管内径D(cm) ,最大血流速度Vmax(cm/s) ,平均血流速度V(cm /s) ,根据公式Q =π(D/2 ) 2 0 .5 7Vmax计算血流量Q (ml/min) ,并将 3 1例患者按Child -Pugh肝功能分级分析两者之间的关系。 结果 ChildA、B、C三级肝硬化门静脉内径无显著差异 (P >0 .0 5 ) ,按ChildA、B、C三级顺序 ,门静脉流速逐渐降低 ,且组间比较有显著差异。门静脉血流量 ,ChildB级较A级血流量有减少 ,但无统计学差异 (P >0 .0 5 )。ChildC级血流量较A和B级减少均有显著性差异 (P <0 .0 0 1)。ChildA、B、C级门静脉逆流发生率分别为 0 % ,18.8% ,85 .3 %。ChildA、C级间比较有显著性差异 (P <0 .0 5 )。结论 多普勒超声检测肝硬化食管静脉曲张破裂大出血患者门静脉血流动力学有助于评价患者的肝储备功能、门静脉高压程度及预后。

Objective To examine the portalvein hemodynamics of esophageal variceal bleeding (EVB) in patients with cirrhosis and analysis the relationship between the changes of the portal hemodynamics and the Child Pugh grade.Methods The portal hemodynamics of EVB were examined in 31 patients with cirrhosis by Color Doppler Ultrasound and their liver fun. ction were graded by the Child Pugh grade.Results The Qpv were no significant difference between Child grade A,B,C groups patients( P >0.05).The Qpv of Child grade C patients was lower than the those of Child grade A ( P <0.001) and Child grade B ( P <0.01).The Qpv of Child grade Bpatients was lower than the those of Child grade A,but no significant difference( P >0.05). The Qpv of Child grade C patients waw the lowerst among threr groups patients( P <0.001). The portal vein countercurrent frequence of Child grade A, B, C were 0%,18.8%,85.3% respectively. The countercurrent frequence were significance difference between Child A and C. Conclusions Examination of EVB in patients with cirrhosis can be used to evaluate the degree of liver function and the portal hypertension and prognosis respectively.