彩色多普勒超声对老年肝硬化患者门静脉和脾静脉血流动力学检测及临床意义
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摘要
[目的]应用彩色多普勒超声检测老年肝硬化患者门静脉系统血流动力学,分析门静脉、脾静脉血流变化与肝硬化病变程度相关性。[方法]选取2012年2月~2014年6月来我院治疗的98例老年肝硬化患者为研究对象,按肝功能(Child-Pugh)分级,另选36例健康者为对照组,采用彩色多普勒超声仪检测门静脉(PV)、脾静脉(SV)、胃左静脉LGV血流速度、血管内径及血流量,并进行统计分析。[结果]老年肝硬化患者PV、SV、LGV内径D均显著高于对照组,随肝功能分级逐渐增加(P<0.01);PV、SV血流速度均显著低于对照组,且随肝功能分级逐渐减慢(P<0.05),LGV流速逐渐增加(P<0.05);PV、SV、LGV血流量显著高于对照组,随肝功能分级逐渐增加(P<0.05);胃左静脉分流指数显著高于对照组(P<0.05)。[结论]老年肝硬化患者门静脉系统血流动力学改变与患者肝功能损伤相关,彩色多普勒超声检测门静脉系统血流动力学变化对于老年肝硬化患者肝功能评估有重要意义。
[Objective]To observe the clinical significance of detection in hemodynamic of portal vein,splenic vein in elderly patients with cirrhosis by using color Doppler ultrasonography,and to analysis the correlation of the portal vein,splenic vein blood flow with the severity of liver cirrhosis.[Methods]98cases of elderly patients with cirrhosis were select from February 2012 to June 2014 in our hospital,they were divided into different groups according to Child-Pugh score.36 healthy people were recruited for control.They underwent color Doppler ultrasonography for collecting data of the diameter,blood flow velocity and blood flow volume of portal vein(PV),splenic vein(SV),left gastric vein(LGV)for statistical analysis.[Results]The diameter of PV,SV,LGV in elderly patients with cirrhosis were significantly higher than that in the control group,the diameter was positively related to Child-Pugh score(P<0.01);blood flow velocity of PV,SV were significantly lower than the control group,and the decrease was related to the Child-Pugh score(P<0.05),while LGV velocity increased with the score(P<0.05).Blood flow volume of PV,SV,LGV were significantly higher than that of control group,and the increase was related to the Child-Pugh score(P<0.05);the left gastric vein shunt index was significantly higher than that in the control group(P<0.05).[Conclusion]It showed that hemodynamics in portal system related to liver dysfunction in elderly patients with cirrhosis.It's of significant importance of assessment of liver function by using color Doppler ultrasonography of portal vein hemodynamics in elderly patients with cirrhosis.
[Objective]To observe the clinical significance of detection in hemodynamic of portal vein,splenic vein in elderly patients with cirrhosis by using color Doppler ultrasonography,and to analysis the correlation of the portal vein,splenic vein blood flow with the severity of liver cirrhosis.[Methods]98cases of elderly patients with cirrhosis were select from February 2012 to June 2014 in our hospital,they were divided into different groups according to Child-Pugh score.36 healthy people were recruited for control.They underwent color Doppler ultrasonography for collecting data of the diameter,blood flow velocity and blood flow volume of portal vein(PV),splenic vein(SV),left gastric vein(LGV)for statistical analysis.[Results]The diameter of PV,SV,LGV in elderly patients with cirrhosis were significantly higher than that in the control group,the diameter was positively related to Child-Pugh score(P<0.01);blood flow velocity of PV,SV were significantly lower than the control group,and the decrease was related to the Child-Pugh score(P<0.05),while LGV velocity increased with the score(P<0.05).Blood flow volume of PV,SV,LGV were significantly higher than that of control group,and the increase was related to the Child-Pugh score(P<0.05);the left gastric vein shunt index was significantly higher than that in the control group(P<0.05).[Conclusion]It showed that hemodynamics in portal system related to liver dysfunction in elderly patients with cirrhosis.It's of significant importance of assessment of liver function by using color Doppler ultrasonography of portal vein hemodynamics in elderly patients with cirrhosis.
引文
[1]骆玉露,胡晓捷.彩色多普勒超声对老年肝硬化门静脉高压的诊断价值[J].中国老年学杂志,2014,34(9):2397-2399.
[2]唐杰,董宝玮.腹部和外周血管彩色多普勒诊断学[M].2版.北京:人民卫生出版社,1999:104,107
[3]刘敏,井月,宋军学,等.肝硬化门静脉高压的血流动力学变化及超声诊断研究[J].中国医药指南,2011,9(35):52-52.
[4]中华医学会传染病与寄生虫病学分会、肝病学分会.病毒性肝炎防治方案[J].中华肝脏病杂志,2000,8(4):324,329.
[5]吕明德,董宝玮.临床腹部超声诊断与介入超声学[M].广州:广东科技出版社,2001:34,36-37.
[6]雷震,杨世梅,李加平,等.超声血流参数对肝硬化门脉高压症的诊断价值[J].世界华人消化杂志,2011,19(17):1839-1842.
[7]黄蔚,贺庆红.彩色多普勒超声检测门脉血流参数对老年肝硬化门静脉高压症的诊断价值[J].南通大学学报:医学版,2012,32(5):405-407.
[8]余灵祥,李志伟,郭晓冬,等.脾切断流术对肝硬化门静脉高压症患者肝功能的影响[J].现代生物医学进展,2013,13(5):950-951.
[9]杨洪枢.肝炎肝硬化脾切除术后门静脉系统血栓形成的原因及预防[J].中国基层医药,2013,20(8):1191-1192.
[10]张潭,宇雪豹,秦艳娟,等.肝硬化患者门静脉血流动力学彩色多普勒超声检测分析[J].中国中西医结合消化杂志,2013,21(5):257-259.
[11]凌文武,全杰荣,卢强,等.彩色多普勒超声对肝移植后胆道并发症的诊断价值[J].中国组织工程研究与临床康复,2011,15(18):3247-3250.
[12]刘军.彩色多普勒超声在门静脉高压症诊断中的应用[J].医学理论与实践,2012,25(12):1496-1497.
[13]吉其胜,曾孝琼,易小洪.彩色多普勒超声在肝硬化门脉高压中的诊断价值[J].西部医学,2012,24(4):712-716.
[14]谢俊明,黄莉文,刘华龙.彩色多普勒超声对肝硬化上消化道出血门静脉血流动力学改变的诊断价值[J].中国现代医生,2013,51(8):90-91.
[15]秦琍.门静脉血液动力学对肝硬化门静脉高压出血的诊断价值[J].中国医药科学,2011,1(21):94-94.
[2]唐杰,董宝玮.腹部和外周血管彩色多普勒诊断学[M].2版.北京:人民卫生出版社,1999:104,107
[3]刘敏,井月,宋军学,等.肝硬化门静脉高压的血流动力学变化及超声诊断研究[J].中国医药指南,2011,9(35):52-52.
[4]中华医学会传染病与寄生虫病学分会、肝病学分会.病毒性肝炎防治方案[J].中华肝脏病杂志,2000,8(4):324,329.
[5]吕明德,董宝玮.临床腹部超声诊断与介入超声学[M].广州:广东科技出版社,2001:34,36-37.
[6]雷震,杨世梅,李加平,等.超声血流参数对肝硬化门脉高压症的诊断价值[J].世界华人消化杂志,2011,19(17):1839-1842.
[7]黄蔚,贺庆红.彩色多普勒超声检测门脉血流参数对老年肝硬化门静脉高压症的诊断价值[J].南通大学学报:医学版,2012,32(5):405-407.
[8]余灵祥,李志伟,郭晓冬,等.脾切断流术对肝硬化门静脉高压症患者肝功能的影响[J].现代生物医学进展,2013,13(5):950-951.
[9]杨洪枢.肝炎肝硬化脾切除术后门静脉系统血栓形成的原因及预防[J].中国基层医药,2013,20(8):1191-1192.
[10]张潭,宇雪豹,秦艳娟,等.肝硬化患者门静脉血流动力学彩色多普勒超声检测分析[J].中国中西医结合消化杂志,2013,21(5):257-259.
[11]凌文武,全杰荣,卢强,等.彩色多普勒超声对肝移植后胆道并发症的诊断价值[J].中国组织工程研究与临床康复,2011,15(18):3247-3250.
[12]刘军.彩色多普勒超声在门静脉高压症诊断中的应用[J].医学理论与实践,2012,25(12):1496-1497.
[13]吉其胜,曾孝琼,易小洪.彩色多普勒超声在肝硬化门脉高压中的诊断价值[J].西部医学,2012,24(4):712-716.
[14]谢俊明,黄莉文,刘华龙.彩色多普勒超声对肝硬化上消化道出血门静脉血流动力学改变的诊断价值[J].中国现代医生,2013,51(8):90-91.
[15]秦琍.门静脉血液动力学对肝硬化门静脉高压出血的诊断价值[J].中国医药科学,2011,1(21):94-94.