食管静脉曲张破裂出血危险因素的超声分析
|
摘要
目的探讨食管静脉曲张(EV)破裂出血的独立危险因素。方法 69例乙肝肝硬化患者分为出血组(31例)和非出血组(38例),采用超声测量门静脉内径和血流速度、脾静脉内径(DSV)和血流速度、脾厚径和脾长径、胃左静脉内径(DLGV)和血流方向。将是否发生EV出血作为因变量,上述超声参数作为自变量,用Logistic回归分析筛选出EV出血的独立危险因素,用卡方检验比较两组DLGV>5.95mm和DSV>10.55mm的发生率。结果 Logistic回归分析显示,DLGV和DSV是EV出血的独立危险因素优势比(OR)=0.458,P<0.01、OR=1.425(P<0.05)。出血组DLGV>5.95mm者占83.9%,高于非出血组28.9%(P<0.01);出血组DSV>10.55mm者占74.2%,高于非出血组的28.9%(P<0.01)。结论 DLGV和DSV是EV出血的独立危险因素。
Objective To investigate the independent risk factors for esophageal varices bleeding.Methods Data of 69 patients with hepatitis B-induced liver cirrhosis were retrospectively analyzed,of whom 31 cases with the history of esophageal bleeding(group A)and 38 cases without the history of esophageal varices bleeding(group B).The esophageal varices bleeding as the dependent variable.The independent variables included the inner diameter and blood flow velocity of portal vein and spleen vein,the thickness and length of the spleen,the inner diameter and blood flow direction of left gastric vein were measured by ultrasound.Logistic regression analysis was performed to screen the independent risk factors.The percentages of the cases with inner diameter of left gastric vein greater than 5.95 mm and that of spleen vein greater than 10.55 mm were calculated in both groups.Results The inner diameters of left gastric vein and spleen vein were the independent risk factors for esophageal varices bleeding(P<0.01 and P<0.05).The percentage of group A with left gastric vein inner diameter greater than 5.95 mm was higher than that of group B(83.9% vs.28.9%)(P<0.01).So did the pleen vein inner diameter greater than 10.55mm(74.2% vs.28.9%)(P<0.01).Conclusion The inner diameters of left gastric vein and spleen vein are the independent risk factors for esophageal varices bleeding.
Objective To investigate the independent risk factors for esophageal varices bleeding.Methods Data of 69 patients with hepatitis B-induced liver cirrhosis were retrospectively analyzed,of whom 31 cases with the history of esophageal bleeding(group A)and 38 cases without the history of esophageal varices bleeding(group B).The esophageal varices bleeding as the dependent variable.The independent variables included the inner diameter and blood flow velocity of portal vein and spleen vein,the thickness and length of the spleen,the inner diameter and blood flow direction of left gastric vein were measured by ultrasound.Logistic regression analysis was performed to screen the independent risk factors.The percentages of the cases with inner diameter of left gastric vein greater than 5.95 mm and that of spleen vein greater than 10.55 mm were calculated in both groups.Results The inner diameters of left gastric vein and spleen vein were the independent risk factors for esophageal varices bleeding(P<0.01 and P<0.05).The percentage of group A with left gastric vein inner diameter greater than 5.95 mm was higher than that of group B(83.9% vs.28.9%)(P<0.01).So did the pleen vein inner diameter greater than 10.55mm(74.2% vs.28.9%)(P<0.01).Conclusion The inner diameters of left gastric vein and spleen vein are the independent risk factors for esophageal varices bleeding.
引文
[1]于中麟,张澍田.食管静脉曲张内镜下分级的初步研究[J].中华消化内镜杂志,2000,17(4):201.
[2]韩蕴新,张志琴,朱雅琪,等.彩色多普勒超声对肝硬化并门静脉高压预测食管静脉曲张出血的探讨[J].中国超声医学杂志,1999,15(8):626.
[3]中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2010年版)[J].中华肝脏病杂志,2011,19(1):13-24.
[4]中华消化内镜协会.食管胃底静脉曲张内镜下诊断和治疗规范试行方案[J].中华消化内镜杂志,2000,17(4):198-199.
[5]彭梅,李凤华,夏建国,等.彩色多普勒超声预测肝硬化食管静脉曲张破裂出血[J].世界华人消化杂志,2004,12(8):1894-1896.
[6]魏国,温贤敏,范合璋,等.彩色多普勒预测食管静脉曲张破裂出血风险的价值[J].四川省卫生管理干部学院学报,2008,27(4):256-258.
[7]李丹,张谊,朱张茜,等.胃左静脉血流参数与食管静脉曲张破裂出血的相关性[J].中华普通外科杂志,2012,27(3):242-243.
[8]肖绍树,贺降福,幸玉玲.B超检测门静脉、脾静脉内径和脾脏厚度对判断食管静脉曲张程度的意义[J].中华超声影像学杂志,1996,5(4):48.
[2]韩蕴新,张志琴,朱雅琪,等.彩色多普勒超声对肝硬化并门静脉高压预测食管静脉曲张出血的探讨[J].中国超声医学杂志,1999,15(8):626.
[3]中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2010年版)[J].中华肝脏病杂志,2011,19(1):13-24.
[4]中华消化内镜协会.食管胃底静脉曲张内镜下诊断和治疗规范试行方案[J].中华消化内镜杂志,2000,17(4):198-199.
[5]彭梅,李凤华,夏建国,等.彩色多普勒超声预测肝硬化食管静脉曲张破裂出血[J].世界华人消化杂志,2004,12(8):1894-1896.
[6]魏国,温贤敏,范合璋,等.彩色多普勒预测食管静脉曲张破裂出血风险的价值[J].四川省卫生管理干部学院学报,2008,27(4):256-258.
[7]李丹,张谊,朱张茜,等.胃左静脉血流参数与食管静脉曲张破裂出血的相关性[J].中华普通外科杂志,2012,27(3):242-243.
[8]肖绍树,贺降福,幸玉玲.B超检测门静脉、脾静脉内径和脾脏厚度对判断食管静脉曲张程度的意义[J].中华超声影像学杂志,1996,5(4):48.