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目的 :观察肝硬化门静脉系统血流动力学改变及其与食道静脉曲张程度、食道静脉曲张出血及肝功能分级的关系。方法 :应用彩色多普勒超声检查比较 60例肝硬化失代偿期患者和 2 5例正常人的门脉血流动力学参数。结果 :肝硬化患者门静脉、脾静脉直径增宽 ,血流速度下降 ,血流量增加 ,与对照组差异显著。各参数与食道静脉曲张程度无关。肝硬化出血组脾静脉血流动力学参数及脾静脉血流量 /门静脉血流量比值较无出血组显著增高。Clild PuphC级组患者门静脉流速及流量明显低于A级组、B级组。结论 :肝硬化门脉血流动力学改变不能用于判断食道静脉曲张程度 ,但脾静脉内径、流速、流量及脾静脉血流量 /门静脉血流量比值对预测食道静脉曲张出血有重要意义。门静脉流速、流量可反映肝功能损害情况。
Objective: To observe the changes of portal hemodynamics in cirrhotic patients and its relationship with esophageal varices, esophageal varices bleeding and liver function grading. Methods: Portal venous hemodynamic parameters of 60 patients with decompensated liver cirrhosis and 25 normal controls were compared by color Doppler ultrasonography. Results: The diameters of portal vein and splenic vein in patients with cirrhosis were widened, the blood flow velocity decreased and the blood flow increased. There was a significant difference with the control group. The parameters have nothing to do with the degree of esophageal varices. Hemodynamic parameters of splenic vein and splenic venous blood flow / portal venous flow in patients with cirrhosis were significantly higher than those without hemorrhage. In the Clild PuphC group, the portal vein velocity and flow rate were significantly lower than those in the A and B groups. CONCLUSION: The changes of portal hemodynamics in cirrhosis can not be used to judge the degree of esophageal varices. However, the diameter, velocity and flow of splenic vein and the ratio of splenic venous flow to portal venous flow are important for the prediction of bleeding of esophageal varices. Portal venous flow rate, traffic can reflect the damage of liver function.