高频超声下的胆囊壁厚度与肝硬化失代偿患者门静脉系统血流动力学改变的相关性研究
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摘要
目的:探讨高频超声下的胆囊壁厚度与肝硬化失代偿患者门静脉系统血流动力学改变的关系。方法:回顾性分析2014年4月至2016年6月期间就诊于我院的肝硬化失代偿期患者64名,根据高频超声的检查结果,将患者分为胆囊不厚组、胆囊单纯增厚组、胆囊双边增厚组。并选取同期24名健康志愿者作为对照组。对比4组患者的门静脉主干血流速度(Vpv)、门静脉主干内径(Dpv)、门静脉主干血流量(Qpv)以及门静脉右支血流速度(Vrpv)、门静脉右支内径(Drpv)、门静脉右支血流量(Qrpv)等指标。并对胆囊壁增厚的高频超声结果与门静脉系统血流动力学改变进行相关性分析。结果:经高频超声检测,4组人员的胆囊壁厚度差异具有统计学意义(P<0.05);4组人员的Vpv、Dpv、Qpv之间均具有差异,差异具有统计学意义(P<0.05);4组人员之间的Drpv及Qrpv差异无统计学意义(P>0.05),仅Vrpv在组间有差异,差异具有统计学意义(P<0.05);前3组与对照组人员Qrpv/Qpv比值差异无统计学意义(P>0.05);Dpv与胆囊壁增厚程度呈正相关(r=0.942,P<0.05),Vpv和Qpv与胆囊壁厚度均呈负相关(r=-0.831,r=-0.927,P均<0.05)。胆囊壁厚度与Drpv、Vrpv及Qrpv之间无相关性(P>0.05)。结论:通过高频超声检测的胆囊壁增厚程度与肝硬化失代偿患者门静脉主干的血流动力学改变息息相关,而与门静脉右支的血流改变无关。
Objective:To investigate the relationship between the high frequency ultrasound results of gallbladder wall thickening and the hemodynamic changes of portal vein system in patients with cirrhosis,so as to provide reference opinions on clinical diagnosis and treatment.Methods:A retrospective analysis from April 2014-June 2016 in our hospital for treatment of patients with decompensated liver cirrhosis in64,according to the high frequency ultrasound examination results,the patients were divided into groups:gallbladder thickness,simple gallbladder thickening group,bilateral gallbladder thickening group.And selected 24 healthy volunteers as control group.Compared 4 groups of patients with portal vein blood flow velocity(Vpv),main portal vein diameter(Dpv),portal vein blood flow(Qpv)and right portal vein blood flow velocity(Vrpv),right portal vein diameter(Drpv),right portal vein blood flow(Qrpv) and other indicators.The results of ultrasonography of gallbladder wall thickening and portal vein hemodynamics change phase Correlation analysis.Results:The high frequency ultrasound detection,with significant differences in the thickness of gallbladder wall in the patients of the 4 groups(P<0.05);The difference of Vpv,Dpv and Qpv were statistically significant amoung 4 groups of patients(P<0.05);While,Drpv and Qrpv were not statistically significant(P>0.05),only Vrpv was statistically significant(P<0.05);There was no significant difference in the ratio of Qrpv/Qpv between the study group and the control group(P>0.05);Dpv was positively correlated with the degree of gallbladder wall thickening(r=0.942,P<0.05),Vpv and Qpv were negatively correlated with gallbladder wall thickness(r=-0.831,r=-0.927,P<0.05).There were no correlation between Vrpv,Qrpv,Drpv and the thickness of gallbladder wall(P>0.05).Conclusion:The high frequency ultrasound of gallbladder wall thickening and the hemodynamic changes of portal vein system in patients with cirrhosis are closely related,and the right branch of portal vein blood flow change Change has nothing to do.
Objective:To investigate the relationship between the high frequency ultrasound results of gallbladder wall thickening and the hemodynamic changes of portal vein system in patients with cirrhosis,so as to provide reference opinions on clinical diagnosis and treatment.Methods:A retrospective analysis from April 2014-June 2016 in our hospital for treatment of patients with decompensated liver cirrhosis in64,according to the high frequency ultrasound examination results,the patients were divided into groups:gallbladder thickness,simple gallbladder thickening group,bilateral gallbladder thickening group.And selected 24 healthy volunteers as control group.Compared 4 groups of patients with portal vein blood flow velocity(Vpv),main portal vein diameter(Dpv),portal vein blood flow(Qpv)and right portal vein blood flow velocity(Vrpv),right portal vein diameter(Drpv),right portal vein blood flow(Qrpv) and other indicators.The results of ultrasonography of gallbladder wall thickening and portal vein hemodynamics change phase Correlation analysis.Results:The high frequency ultrasound detection,with significant differences in the thickness of gallbladder wall in the patients of the 4 groups(P<0.05);The difference of Vpv,Dpv and Qpv were statistically significant amoung 4 groups of patients(P<0.05);While,Drpv and Qrpv were not statistically significant(P>0.05),only Vrpv was statistically significant(P<0.05);There was no significant difference in the ratio of Qrpv/Qpv between the study group and the control group(P>0.05);Dpv was positively correlated with the degree of gallbladder wall thickening(r=0.942,P<0.05),Vpv and Qpv were negatively correlated with gallbladder wall thickness(r=-0.831,r=-0.927,P<0.05).There were no correlation between Vrpv,Qrpv,Drpv and the thickness of gallbladder wall(P>0.05).Conclusion:The high frequency ultrasound of gallbladder wall thickening and the hemodynamic changes of portal vein system in patients with cirrhosis are closely related,and the right branch of portal vein blood flow change Change has nothing to do.
引文
[1]吕俊英.彩色多普勒超声对35例肝癌血管检测诊断临床价值的探索[J].中国民康医学,2012,24(1):56-57.
[2]闫丽娟,马苏美,周怀琪,等.肝硬化胆囊壁的高频超声分型与门静脉主干及右支血流动力学的关系[J].中国医学影像技术,2010,26(3):525-528.
[3]柯黎黎,王守彪.彩超观察肝脏血流、胆系变化与临床相关性研究[J].医学理论与践,2011,24(15):1796-1797.
[4]3林中能.彩色多普勒超声诊断肝硬化门脉高压和侧支循环的价值[J].医学影像学杂志,2011,21(3):454-455.
[5]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(6):324-329.
[6]程黎明,陈国忠,钟世镇,等.肝硬化时胆囊壁增厚的机制及其临床意义[J].中华肝胆外科杂志,2003,9(8):506-507.
[7]李琛,杨志刚,马恩森,等.肝硬化失代偿患者胆囊壁增厚与门静脉系统血流动力学改变的相关性探讨[J].生物医学工程学杂志,2010,27(3):583-585.
[8]齐石,李宏军,赵大伟,等.胆囊壁增厚与乙型肝炎后肝硬化相关因素研究[J].磁共振像,2011,02(6):408-412.
[9]杨东红,闫丽娟,陈飞,等.肝炎肝硬化门静脉高压症胆囊壁增厚时的肝动脉血流动力学变化研究[J].临床超声医学杂志,2011,13(1):52-53.
[10]倪静.彩色B超在肝硬化门脉高压中的诊断价值研究[J].实用心脑肺血管病杂志,2013,21(8):95-96.
[11]郑浙悦,王晓,金国栋,等.腹部B超对肝硬化门脉高压的诊断价值[J].中国基层医药,2013,20(4):570-571.
[12]伍海翔,许国辉,朴雯雯,等.超声造影和增强CT诊断疑难肝局灶性病变的价值[J].中华超声影像学杂志,2013,22(2):177-178.
[13]钟昕.超声检查在肝硬化门静脉高压诊断中的临床应用[J].检验医学与临床,2014,11(14):1921-1922,1924.
[2]闫丽娟,马苏美,周怀琪,等.肝硬化胆囊壁的高频超声分型与门静脉主干及右支血流动力学的关系[J].中国医学影像技术,2010,26(3):525-528.
[3]柯黎黎,王守彪.彩超观察肝脏血流、胆系变化与临床相关性研究[J].医学理论与践,2011,24(15):1796-1797.
[4]3林中能.彩色多普勒超声诊断肝硬化门脉高压和侧支循环的价值[J].医学影像学杂志,2011,21(3):454-455.
[5]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(6):324-329.
[6]程黎明,陈国忠,钟世镇,等.肝硬化时胆囊壁增厚的机制及其临床意义[J].中华肝胆外科杂志,2003,9(8):506-507.
[7]李琛,杨志刚,马恩森,等.肝硬化失代偿患者胆囊壁增厚与门静脉系统血流动力学改变的相关性探讨[J].生物医学工程学杂志,2010,27(3):583-585.
[8]齐石,李宏军,赵大伟,等.胆囊壁增厚与乙型肝炎后肝硬化相关因素研究[J].磁共振像,2011,02(6):408-412.
[9]杨东红,闫丽娟,陈飞,等.肝炎肝硬化门静脉高压症胆囊壁增厚时的肝动脉血流动力学变化研究[J].临床超声医学杂志,2011,13(1):52-53.
[10]倪静.彩色B超在肝硬化门脉高压中的诊断价值研究[J].实用心脑肺血管病杂志,2013,21(8):95-96.
[11]郑浙悦,王晓,金国栋,等.腹部B超对肝硬化门脉高压的诊断价值[J].中国基层医药,2013,20(4):570-571.
[12]伍海翔,许国辉,朴雯雯,等.超声造影和增强CT诊断疑难肝局灶性病变的价值[J].中华超声影像学杂志,2013,22(2):177-178.
[13]钟昕.超声检查在肝硬化门静脉高压诊断中的临床应用[J].检验医学与临床,2014,11(14):1921-1922,1924.