肝硬化失代偿期超声征象与评价

B-mode Ultrasonographic Estimation in Patients with Deconpensated Hepatocirrhosis

目的 探讨肝硬化失代偿期门脉高压超声征象的出现率。方法 对 1 2 3例患者测量门静脉主干入肝处的宽度 ,肝侧脾静脉 (胰后段 )及脾门区脾静脉的宽度 ,脾厚度及平卧位吸气时肋缘下脾长度 ,探测腹水 ,观察肝圆韧带内脐静脉是否重开 ,肋间探测有无胆囊双边影征 ;将出现以上征象中一种征象的患者设定为 组 ,出现两种征象的患者设定为 组 ,同理出现六种征象的患者设定为 组。结果 门静脉主干扩张、脾肿大、腹水、胆囊双边影征、脾静脉扩张、脐静脉重开的出现率分别为 5 6 .91 %、85 .36 %、78.86 %、5 2 .85 %、30 .0 8%、39.0 2 % ; 、 、 、 、 、 组出现率分别为 1 4 .6 3%、2 6 .83%、1 3.82 %、1 2 .1 6 %、1 1 .38%、2 1 .1 4 % ;以上各组的门静脉主干内径分别为 (1 .0 6 1± 0 .0 70 ) cm、(1 .1 6 1± 0 .1 2 4 ) cm、(1 .32 7± 0 .0 6 5 ) cm、(1 .373± 0 .2 2 8) cm、(1 .394± 0 .1 83) cm、(1 .4 32± 0 .2 0 8) cm;将以上各组的门静脉主干内径进行 q检验发现 :: 、 、 、 均 > > (P<0 .0 1 ) , 、 、 各组之间均 P>0 .0 5 , > (P<0 .0 1 ) , > (P<0 .0 5 ) , 、 间 P>0 .0 5 ,在 、 、 、 各组中门静脉主干扩张的患者占 87.5 % (6 3/72 )。在 、 组中门静脉主干扩张的患者占 1 3.72 %

Objective To study the displayed rates of ultrasound signs of portal hypertension in the patients with deconpemsated hepatocirrhosis.Methods The inlet diameters of portal and splenic veins proximal to the hepatic protal the thickness and the subcostal splenic length in inspiratory phase at the recumbant position were meausured in 123 patients.The signs of ascites,umbilical vein reopening in round ligment,and double layer structure of grallbladder wall in the intercostal space were observed.Patients who had one sign of them were defined as these signs were group Ⅰ;Patients who had two signs as group Ⅱ;Patients who had six signs in these signs as group Ⅵ.Results The displayed rates of pylephlebectasis,splenomagaly,ascites,double layer structures of grallblader wall,splenic veins expansion and umbilical veins ropening were 56 91%?85 36%?78 86%?52 85%?30 08%?39 02% respectively;the display rates of groups Ⅰ～Ⅵ were 14 63%?26 83%?13 92%?12 16%?11 38%?21 14% respectively;The average diameter of common portal veins of groups Ⅰ～Ⅵ were 1 061±0 070 cm?1 161±0 124 cm?1 327±0 065 cm?1 373±0 065 cm?1 373±0 228 cm?1 394±0 183 cm?1 432±0 208 cm respectively;According to Newman Keuls test to the diameter of common portal veins in each group,the diameter in the groups Ⅲ,Ⅳ,Ⅴ,Ⅵ were all bigger that in group Ⅱ,and in group Ⅱ was bigger than that in group Ⅰ( P <0 01);in the groups Ⅳ,Ⅴ,Ⅵ There were no significant differences( P >0 05);in the group Ⅵ was bigger that in group Ⅲ( P <0 01);in the group Ⅴ was bigger than that in group Ⅲ( P <0 05);the group Ⅲ,Ⅳ were no significant difference( P >0 05).The patients with pylephlebectasis were 87 6%(63/72)in groups Ⅲ,Ⅳ,Ⅴ,Ⅵ,and were 13 72%(7/51)in groups Ⅰ,Ⅱ.Conclusions Splenomagaly and ascites were the most common ultrasound signs of portal hypertension,It was the exacerbation proof of decompensated hepatocirrhosis that patients appeared three or more ultrasound signs and symptoms.