肝硬化门静脉高压门脉血流动力学检测及其rn临床意义

摘要

目的探讨肝硬化门脉高压患者门脉血流动力学状态并分析其与Child-Pugh肝功能分级的关系。方法利用多普勒超声技术检测了100例肝硬化门脉高压患者及24例正常人门脉血流动力学状态，并将100例肝硬化门脉高压患者按Child-Pugh肝功能分级分析两者之间的关系。结果肝硬化门脉高压门脉血流动力学检测与正常对照组比较，门脉高压组门静脉（PV）内径明显增宽、血流速明显减慢、血流量参数明显增加，差异有显著性意义（P<0.01）;脾静脉（SV）、肠系膜上静脉（SMV）内径（D）、血流速度（V）、血流量参数（Q）也有类似改变。A、B、C三级肝硬化的PV内径，按A、B、C顺序显示门静脉宽度逐渐增宽，C级的Dpv较A、B级均有显著性增宽（P<0.05）,A、B级间差异无显著性意义（P>0.05）,但B级较A级也有增宽趋势。按A、B、C顺序显示门静脉血流速度逐渐降低，且各级间比较差异有显著性意义（P<0.05）。A、B 、C级的Q p v相互比较无统计学差异（P>0.05）。结论多普勒超声检测门脉血流动力学有助于评价肝硬化患者的肝储备功能、门静脉高压程度及预后。%Objective　To examinate the portal system hemo dynamics of portal hypertension in patients with cirrhosis and analysis the rela tionship between the changes of the portal system hemodynamics and the Child-Pu gh grade.Methods　The portal system hemodynamics of portal hypertension we re examined in 100 patients with cirrhosis and 24 normal subjects used colo r Doppler ultrasound and 100 cirrhosis patients were graded by the Child-Pugh g rade.Results　There were significant changes in the portal system hemo dynamics of portal hypertension between cirrhosis and 24 normal subjects,the di ame ter of the portal vein(Dpv),the splenic vein(Dsv) and the superior mesenteric vein(Dsmv), the speed of the portal vein(Vpv),the spleni c vein(Vsv) and the superior mesenteric vein(Vsmv) ,the flow of the portal vein(Qpv),the splenic vein(Qsv) and the superior mesenteric v ein(Qsmv) were significantly increased (P<0.01),respectively.The Dpv of Child grade C patients were wider than the those of Child grade A a nd B patients(P<0.05), the Vpv of Child grade C patients had mo re decrease than the those of Child grade A and B patients(P<0.05), but Qpv was were no significant difference between Child grade A,B and C gro ups patients(P>0.05). Conclusions　Examination of the portal system hemodynamics of por tal hypertension in patients with cirrhosis can be used to evaluate the degree o f liver function and the portal hypertension in cirrhosis patients.