肝硬化门静脉高压的血流动力学变化及超声诊断观察

目的探讨超声诊断肝硬化门静脉高压的血流动力学变化的临床价值和意义。方法选取我院收治的148例肝硬化门静脉高压患者作为研究对象。另取健康对照组40例。采用超声检查患者门静脉(PV),脾静脉(SV)及肠系膜上静脉(SMV)的内径D、平均血流速度V和血流量Q,比较两组检查后的数据结果;对肝硬化进行分级,比较各级肝硬化的血流动力学变化。结果肝硬化组患者较对照组的PV、SV、SMV内径明显增宽,Q增加、V减慢,P<0.05,具有统计学意义;A、B、C三级的PV内径递增,但P>0.05,不具有统计学意义;而V值三级之间差异较为明显,P<0.05,具有统计学意义;而A、B组在Q上无差异(P>0.05),C组差异较为明显(P<0.05)。结论应用超声检查肝硬化门静脉高压可准确分析出其血流动力学变化,对肝功能判断和治疗方案的选择有着重要的指导意义。

Observation of Haemodynamics Changes and Ultrasonic Diagnosis for Liver Cirrhosis and Portal Hypertension

Objective To explore the clinical values of haemodynamics changes and ultrasonic diagnosis for liver cirrhosis and portal hypertension. Methods 148 patients with liver cirrhosis and portal hypertension in our hospital were selected as the study objects, and another 40 healthy people were selected as the control group. Inner diameter （D）, average blood velocity （V） and quantity （Q） of portal vein （PV）, splenic vein （SV）, and superior mesenteric vein （SMV） were detected by ultrasound, then compared the detection results and graded liver cirrhosis, haemodynamics changes of all grades were compared. Results PV, SV, SMV of liver cirrhosis group had widened significantly compared with control group, and Q increased, V slowed down, P〈0.05, with statistical significance;PV inner diameter of grade A, B, C increased gradually, P〉0.05, differences were not statistically significant;but differences of V value between three grades were significant, P〈0.05, the result was statistically significant;there was no significant differences between grade A, B in Q value, but differences with grade C were statistically significant （P〈0.05）. Conclusion Applying ultrasound in the examination of liver cirrhosis and portal hypertension can analyze the haemodynamics changes accurately, having important values in liver function examination and treatment chooses.