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目的：本研究旨在探讨多普勒超声检测脾静脉血流量大于门静脉血流量与肝硬化门静脉系统食管胃底静脉曲张及其破裂出血的关系。方法：对５８例肝硬化患者门脉系统血流进行彩色多普勒血流检测，其中３０例患者脾静脉血流量大于门静脉血流量（即ＱＳＶ＞ＱＰＶ），２８例患者门静脉血流量大于脾静脉血流量（即ＱＰＶ＞ＱＳＶ），所有患者均在三个月内同时或先后进行电子胃镜及上消化道造影检查，确定食管胃底静脉曲张或破裂出血的发生率。结果：ＱＳＶ＞ＱＰＶ组的脾静脉血流量、脾静脉直径、脾脏厚度均大于ＱＰＶ＞ＱＳＶ组的测值，而其门静脉直径及血流量均小于ＱＰＶ＞ＱＳＶ组的测值。经电子胃镜及上消化道造影检查证实，ＱＳＶ＞ＱＰＶ组患者食管胃底静脉曲张发生率及曲张静脉破裂出血率均较ＱＰＶ＞ＱＳＶ组明显增高。结论：脾静脉血流量超过门静脉血流量与食管胃底静脉曲张及其破裂出血有密切关系。一旦多普勒超声检测出现脾静脉血流量高于门静脉血流量这一血流动力学改变，则预示肝硬化患者多有门－体侧支循环开放，即静脉曲张，并有破裂出血倾向。
OBJECTIVE: This study was designed to investigate the relationship between the splenic venous blood flow detected by Doppler ultrasonography and portal vein blood flow and esophageal varices and rupture hemorrhage in the portal system of liver cirrhosis. Methods: Fifty-eight patients with cirrhosis were examined by color Doppler flow in portal vein blood flow. Thirty patients had splenic venous blood flow greater than portal venous flow (QSV> QPV), 28 patients had portal vein blood flow greater than that of splenic vein Blood flow (QPV> QSV), all patients within three months at the same time or successively by electronic endoscopy and upper gastrointestinal imaging to determine the incidence of esophageal varices or rupture of bleeding. Results: The splenic venous blood flow, splenic vein diameter and spleen thickness in QSV> QPV group were all higher than those in QPV> QSV group, while the diameter of portal vein and blood flow in QSV> QPV group were less than those in QPV> QSV group. Electron endoscopy and upper gastrointestinal angiography confirmed that QSV> QPV patients with esophageal varices and varicose vein hemorrhage rate were significantly higher than the QPV> QSV group. Conclusion: The splenic venous blood flow exceeding portal vein blood flow is closely related to esophageal varices and rupture hemorrhage. Once the Doppler ultrasound examination of splenic blood flow is higher than the portal vein blood flow hemodynamic changes, it is indicated in patients with cirrhosis more door - body collateral circulation, namely varicose veins, and a tendency to rupture bleeding.