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目的探讨肝硬化门脉高压症患者门脉血流动力学的改变及其临床意义。方法将门静脉高压症患者分成EVB阳性组和EVB阴性组,应用彩色多普勒超声显像仪分别测定门静脉内径(PVD)、脾静脉内径(SVD)、门静脉血流速度(PVV)、脾静脉血流速度(SVV)、并计算出门静脉血流量(PVFV)、脾静脉血流量(SVFV)、门静脉淤血指数(PVCI)脾静脉淤血指数(SVCI)。结果 EVB阳性者的PVD显著大于阴性者(P<0.01),PVCI及SVCI显著大于阴性者(P<0.05),SVV显著小于阴性者(P<0.05),在肝功能不同的患者之间Child-PughC级患者的PVD及PVCI显著大于Child-PughA级和Child-PughB级患者(P<0.01),C级患者的PVV显著小于A级患者(P<0.05)。结论肝硬化门脉高压症患者门静脉系统的血流量增多,阻力增大,而且其程度受肝功能损坏程度的影响,且与食管静脉曲张破裂出血相关。
Objective To investigate the changes of portal hemodynamics in cirrhotic patients with portal hypertension and its clinical significance. Methods Patients with portal hypertension were divided into two groups: EVB positive group and EVB negative group. Color Doppler ultrasound imaging was used to measure the diameter of the portal vein (PVD), the diameter of the splenic vein (SVD), the velocity of the portal vein (PVV) Flow rate (SVV), and calculate the portal vein blood flow (PVFV), splenic vein blood flow (SVFV), portal vein congestion index (PVCI) spleen venous congestion index (SVCI). Results The EVB positive patients had significantly greater PVD than those with negative HBV DNA (P <0.01), PVCI and SVCI (P <0.05), and significantly lower SVV (P <0.05) The PVD and PVCI of PughC patients were significantly higher than that of Child-PughA and Child-PughB patients (P <0.01). The PVV of patients with PughC was significantly lower than that of patients with A (P <0.05). Conclusions The portal vein system in patients with cirrhosis and portal hypertension has increased blood flow and increased resistance, and the degree is affected by the degree of liver damage and is associated with esophageal variceal bleeding.