彩色多普勒超声联合瞬间弹性成像评估肝硬化食管胃静脉曲张出血的应用价值

Value of color Doppler ultrasound combined with transient elastography in the evaluation of cirrhotic esophagogastric varices bleeding

目的探讨彩色多普勒超声联合瞬间弹性成像应用于临床诊断肝硬化食管胃静脉曲张出血的价值。方法选取我院200例肝硬化食管胃静脉曲张患者进行分析,根据临床检查结果将其分为对照组与观察组,其中对照组为肝硬化食管胃静脉曲张出血患者100例;另100例肝硬化食管胃静脉曲张未出血患者为观察组。两组患者均行彩色多普勒超声和瞬间弹性成像检查。记录和比较两组患者门静脉血流动力学指标(内径、血流速度、血流量)及瞬间弹性成像检测值。计算彩色多普勒超声联合瞬间弹性成像诊断情况。结果观察组患者门静脉内径为(13.69±2.72)mm明显小于对照组(16.25±1.69)mm,血流速度为(14.21±1.49)cm/s明显高于对照组(11.98±2.59)cm/s,P<0.05;血流量为(1162.74±239.88)ml/s与对照组(1174.25±229.76)ml/s比较,P>0.05。观察组瞬间弹性成像检测值为(22.93±7.02)KPa明显低于对照组(28.47±9.57)KPa,P<0.05。彩色多普勒超声联合瞬间弹性成像检查临床诊断准确率为95.0%(190/200)。结论临床应用彩色多普勒超声联合瞬间弹性成像检测肝硬化食管胃静脉曲张患者门静脉内径和血流速度等指标来判断患者是否存在出血风险,且诊断价值较高,对指导临床诊治具有重要价值。

Objective To investigate the value of color Doppler ultrasound combined with transient elastography in the diagnosis of cirrhotic esophagogastric varices bleeding.Methods A total of 200 patients with cirrhosis of esophagogastric varices who were admitted to the hospital from December 2017 to December 2018 were enrolled.According to the results of clinical examination,they were divided into control group and observation group.The control group was cirrhotic esophagogastric vein,with 100 patients with variceal hemorrhage;another 100 patients with cirrhosis of esophagogastric varices without bleeding were observed.Color Doppler ultrasound and transient elastography were performed in both groups.The portal hemodynamic parameters(inner diameter,blood flow velocity,blood flow)and transient elastography were recorded and compared between the two groups.The diagnosis of color Doppler ultrasound combined with transient elastography was calculated.Results In the observation group,the diameter of the portal vein was(13.69±2.72)mm,which was significantly smaller than that of the control group(16.25±1.69)mm,and the blood flow velocity was(14.21±1.49)cm/s,which was significantly smaller than that of the control group(11.98±2.59)cm/s.<0.05;blood flow was(1162.74±239.88)ml/s compared with the control group(1174.25±229.76)ml/s,P>0.05.The instantaneous elastography detection value of the observation group was(22.93±7.02)KPa,which was significantly lower than that of the control group(28.47±9.57)KPa,P<0.05.The accuracy of clinical diagnosis of color Doppler ultrasound combined with transient elastography was 95.0%(190/200).Conclusion Clinical application of color Doppler ultrasound combined with transient elastography in the detection of portal vein diameter and blood flow velocity in patients with cirrhotic esophagogastric varices can determine whether patients have bleeding risk and the high diagnostic value is of great value for guiding clinical diagnosis and treatment.