彩色多普勒对肝硬化门脉系统血流动力学改变的意义

The Application of Doppler Color Flow Imaging in Change Monitoring in Portal System of Patients with Hepatic Cirrhosis

目的 :观察肝硬化患者门静脉系统血流动力学改变并探讨其对预后的影响。方法 :用彩色多普勒测量肝硬化腹水、无腹水及上消化道出血患者门静脉和脾静脉内径、血流速度及血流量 ,同时检测肝功能 ,并设正常对照组。结果 :肝硬化患者门静脉、脾静脉内径及血流量大于正常对照组 (P <0 0 1) ,门静脉血流速度小于正常对照组 (P <0 0 1)。肝硬化消化道出血组门静脉血流速度小于腹水组和无腹水组 (P <0 0 5 ) ,肝硬化腹水组和消化道出血组门静脉血流量小于无腹水组 (P <0 0 5 ) ,肝硬化消化道出血组脾静脉血流速度大于无腹水组及腹水组 (P <0 0 1)。结论 :脾静脉血流量的增多是导致门静脉高压的重要原因之一 ,并导致肝功能预后不良 ,脾静脉血流速度增快的肝硬化患者容易并发上消化道出血。

Objective: To study the clinical significance of doppler color flow imaging in monitoring the hemodynamic changes in portal system of patients with hepatic cirrhosis, and its influence on prognosis of the disease. Methods: Using doppler color flow imaging to measure the diameters of portal vein and splenic vein, blood stream velocity, and blood flow quantity of patients with hepatic cirrhosis that had and hadn’t ascitic fluid (ASC and no-ASC groups), and that had the complication of hemorrhage of upper digestive tract (HEM group). In the same time, hepatic function of the patients were detected, and a group of healthy people were checked as normal control (COL group). Results: The diameters and blood flow quantity of portal vein and splenic vein of the patients were larger than those of control group (P<0.01). The blood stream velocity of portal vein of the patients was slower than that of control group (P<0.01). The blood stream velocity in portal vein of the patients in HEM group was slower than those of patients in ASC and no-ASC groups (P<0.05). The blood flow amounts in veins of patients in ASC and HEM groups were smaller than that of no-ASC group (P<0.05), while the blood stream velocity in splenic vein of patients of HEM group was faster than those in ASC and no-ASC groups (P<0.01). Conclusions: The increase of splenic vein blood flow quantity is an important cause resulting portal hypertension and hepatic function damage. The hepatic cirrhosis patients with faster splenic vein blood stream velocity could easily caught complication of superior digestive tract hemorrhage.