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目的用多排CT测量门静脉系血管内径大小,从而评估其在预测门静脉高压致上消化道大出血中的临床价值。资料与方法将门静脉高压患者分为上消化道出血组和未出血组,所有患者行64排螺旋CT增强扫描,以获取两组患者的门静脉、脾静脉、胃冠状静脉、食管胃底曲张静脉的直径,再将各血管直径分为不同等级资料,分别用方差分析两组间差异性、卡方分析不同等级资料间的差异性及各等级资料的出血患者百分比例、Logistic回归分析各血管在出血中的独立危险因素。结果两组患者的门静脉、胃冠状静脉、食管胃底曲张静脉直径之间有显著差异性(P<0.05);各等级资料间有明显差异性(P<0.05),当门静脉宽度≥18 mm、胃冠状静脉宽度≥8 mm、食管胃底曲张静脉宽度≥6 mm时出血的比例明显增加;胃冠状静脉、食管胃底曲张静脉宽度在该出血中是独立危险因素。结论门静脉、胃冠状静脉、食管胃底曲张静脉的直径在预测上消化道出血中有明显意义。
Objective To evaluate the clinical value of portal vein vascular diameter by multi-slice CT in order to evaluate its clinical value in predicting portal hemorrhage due to portal hypertension. Materials and Methods Patients with portal hypertension were divided into upper gastrointestinal bleeding group and non-bleeding group. All patients underwent enhanced CT scan with 64-slice spiral CT to obtain portal vein, splenic vein, gastric coronary vein, esophageal varices Diameter, and then the blood vessels were divided into different grades of data were analyzed by variance analysis of differences between the two groups, chi-square analysis of the differences between the different grades of data and the percentage of patients with bleeding grade data, Logistic regression analysis of blood vessels in the bleeding In the independent risk factors. Results There were significant differences in the diameters of portal vein, gastric coronary vein and esophageal varices between the two groups (P <0.05). There was significant difference between the two grades (P <0.05). When the portal vein width was ≥18 mm, Gastric coronary vein width ≥ 8 mm, esophageal varicose vein width ≥ 6 mm bleeding increased significantly; gastric coronary vein, esophageal varices width in this bleeding is an independent risk factor. Conclusions The diameter of portal vein, gastric coronary vein and esophageal varices is significant in predicting upper gastrointestinal bleeding.