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目的寻找一种既能对肝硬变所致门脉压增高、侧支循环的建立、开放以及门 -体分流和肝、脾功能进行综合判断 ,又能对早期肝硬变和肝硬变进行鉴别诊断的方法。方法经直肠给药测算心 /肝比值 ,换算出每一时相门脉压 ,对肝硬变及病理进程与门脉压的关系进行判断。结果正常和肝炎门脉压在晚期有明显差异 (P<0 .0 5 )。肝硬变门脉压与其他组有明显差异 (P<0 .0 5 )。早期肝硬变介于正常、肝炎和肝硬变之间 ,与其他组门脉压比较有明显差异 (P<0 .0 5 )。在显像后期 Child-pugh分级有明显差异 (P<0 .0 5 )。门脉压与H/ L比值两者之间呈正相关 (r=0 .478,P<0 .0 1)。分级均有明显差异 (P<0 .0 5 )。门脉压与 H/ L比值两者之间呈正相关 (r=0 .478,P<0 .0 1)。结论时相法肝门脉回流显像时患者在早期 H/ L比值≥ 0 .65和经公式换算的门静脉压≥ 1.9k Pa或者腔静脉与门脉压差≥ 1.5 k Pa时 ,表明为肝硬变状态 ;如果 H/ L比值在 0 .3 2～ 0 .64和门静脉 1.0 3～ 1.89k Pa考虑为早期肝硬变。采用时相法 H/ L比值及推算的门脉压对肝炎、肝硬变造成的肝功能减低、门 -体分流和肝门脉回流的诊断具有重要意义 ,是一项比较灵敏、简单可靠的无创性方法 ,对晚期肝硬变手术 ,肝硬变病理过程的判断提供帮助。
Aim To find a way to not only increase the portal pressure caused by cirrhosis, collateral circulation, open and door-body shunt and liver and spleen function comprehensive judgment, but also for early cirrhosis and cirrhosis Methods of differential diagnosis. Methods The rectum was used to calculate the ratio of heart / liver, and the portal pressure of each phase was calculated. The relationship between cirrhosis and pathological process and portal pressure was evaluated. Results of normal and portal pressure of hepatitis in the late significant difference (P <0. 05). Liver cirrhosis portal pressure and other groups were significantly different (P <0. 05). Early cirrhosis between normal, hepatitis and cirrhosis, and other groups were significantly different portal pressure (P <0. 05). There was a significant difference in Child-pugh classification at the end of imaging (P <0.05). There was a positive correlation between portal pressure and H / L ratio (r = 0.488, P <0.01). There were significant differences in grading (P <0.05). There was a positive correlation between portal pressure and H / L ratio (r = 0.488, P <0.01). Conclusions Patients with HGR ≥0.65 at the early phase and hepatic portal venous pressure ≥ 1.9 kPa by the formula or a pressure difference between the vena cava and the portal vein ≥ 1.5 kPa at the time of hepatic portal venography show a liver Hardened state; If the H / L ratio of 0.32 ~ 0.64 and portal vein 1.03 ~ 1.89k Pa consider early cirrhosis. The use of phase method H / L ratio and estimated portal pressure on hepatitis, liver cirrhosis caused by reduced liver function, portal-body shunt and diagnosis of hepatic portal vein reflux is of great significance, is a relatively sensitive, simple and reliable Noninvasive methods, the diagnosis of advanced liver cirrhosis surgery, liver cirrhosis pathological help.