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目的 :运用彩色多普勒超声对肝硬化及食管静脉曲张患者血流动力学的变化进行研究 ,旨在探讨肝硬化患者食管静脉曲张程度与血流动力学的关系及食管曲张静脉结扎术 (EVL)对体循环血流动力学的影响。方法 :运用彩色多普勒超声对 1 0例正常人、 2 0例肝硬化无食管静脉曲张患者、 2 0例食管静脉曲张患者 EVL术前及术后 1天体循环血流动力学参数进行了检测和比较。结果 :肝硬化患者平均动脉压 (MAP)、外周血管阻力指数 (SVRI)明显降低 ;奇静脉血流量 (AZBF)增多 ,心脏指数 (CI)明显增加 ;且与食管静脉曲张程度有关 ,EVL术后 MAP、 SVRI明显升高 ,AZBF减少 ,CI降低 ;肝硬化患者二尖瓣口 E/ A比值减小 ;食管静脉曲张组 PEP/ LVET比值增大。结论 :肝硬化患者存在明显的高动力循环状态 ,左心舒张功能减退 ;左心收缩功能受损。与门脉高压食管静脉曲张程度有一定的关系 ,EVL术能改善高动力循环状态
OBJECTIVE: To study the changes of hemodynamics in patients with cirrhosis and esophageal varices by color Doppler ultrasonography to explore the relationship between esophageal varices and hemodynamics in patients with cirrhosis and esophageal varices ligation (EVL ) On systemic hemodynamics. Methods: The color Doppler echocardiography was used to detect the systemic hemodynamic parameters in 20 normal subjects, 20 patients with cirrhosis without esophageal varices and 20 patients with esophageal varices before and after operation. And compare. Results: Mean arterial pressure (MAP) and peripheral vascular resistance index (SVRI) in patients with cirrhosis were significantly lower than those in patients with cirrhosis. The increase of azygous blood flow (AZBF) and cardiac index (CI) were significantly associated with esophageal varices. MAP, SVRI increased significantly, AZBF decreased, CI decreased; patients with cirrhosis mitral valve E / A ratio decreased; esophageal varices group PEP / LVET ratio increased. Conclusion: There is obvious hyperdynamic circulatory state in patients with cirrhosis, left ventricular diastolic dysfunction and impaired left ventricular systolic function. There is a certain relationship with the degree of portal hypertension esophageal varices, EVL surgery can improve high power cycle status