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目的 探讨肝硬化食管静脉曲张破裂大出血患者门静脉血流动力学状态并分析其与Child—Pugh肝功能分级的关系。方法 运用彩色多普勒技术检测 3 1例肝硬化食管静脉曲张破裂大出血患者门脉血流动力学状态 ,测定门静脉的血管内径D(cm) ,最大血流速度Vmax(cm/s) ,平均血流速度V(cm /s) ,根据公式Q =π(D/2 ) 2 0 .5 7Vmax计算血流量Q (ml/min) ,并将 3 1例患者按Child -Pugh肝功能分级分析两者之间的关系。 结果 ChildA、B、C三级肝硬化门静脉内径无显著差异 (P >0 .0 5 ) ,按ChildA、B、C三级顺序 ,门静脉流速逐渐降低 ,且组间比较有显著差异。门静脉血流量 ,ChildB级较A级血流量有减少 ,但无统计学差异 (P >0 .0 5 )。ChildC级血流量较A和B级减少均有显著性差异 (P <0 .0 0 1)。ChildA、B、C级门静脉逆流发生率分别为 0 % ,18.8% ,85 .3 %。ChildA、C级间比较有显著性差异 (P <0 .0 5 )。结论 多普勒超声检测肝硬化食管静脉曲张破裂大出血患者门静脉血流动力学有助于评价患者的肝储备功能、门静脉高压程度及预后。
Objective To investigate the portal hemodynamics in cirrhotic patients with esophageal variceal bleeding and analyze its relationship with Child-Pugh liver function classification. Methods The portal hemodynamics of 31 patients with cirrhosis esophageal variceal bleeding were detected by color Doppler. The diameter of the portal vein D (cm), the maximum blood flow velocity Vmax (cm / s), the average blood volume Flow rate V (cm / s), blood flow Q (ml / min) was calculated according to the formula Q = π (D / 2) 2 0.57Vmax, and 31 patients were classified according to Child-Pugh function The relationship between. Results There was no significant difference in the diameter of portal vein between ChildA, B and C (P> 0.05). According to the order of ChildA, B and C, the flow velocity of portal vein decreased gradually and there was a significant difference between the two groups. There was a decrease in portal vein blood flow, ChildB level compared with A level, but no significant difference (P> 0.05). There was a significant difference in ChildC blood flow compared with A and B (P <0.01). ChildA, B, C-class portal vein reflux rates were 0%, 18.8%, 85.3%. ChildA, C levels were significantly different (P <0. 05). Conclusions Doppler ultrasound in detecting portal vein hemodynamics in patients with cirrhosis and esophageal variceal bleeding is helpful to evaluate the patients’ liver reserve function, portal hypertension and prognosis.