胆囊壁增厚的高频超声结果与肝硬化失代偿患者门静脉系统血流动力学改变的关系研究

摘要

目的 探讨胆囊壁增厚的高频超声结果与肝硬化失代偿患者门静脉系统血流动力学改变的关系,以期对临床诊疗提供参考意见.方法 回顾性分析自2012年4月～2015年3月期间就诊于我院的肝硬化失代偿期患者64名,根据高频超声的检查结果,将患者分为:胆囊不厚组、胆囊单纯增厚组、胆囊双边增厚组.并选取同期24名健康志愿者作为对照组.对比4组患者的门静脉主干血流速度(Vpv)、门静脉主干内径(Dpv)、门静脉主干血流量(Qpv)以及门静脉右支血流速度(Vr-pv)、门静脉右支内径(Drpv)、门静脉右支血流量(Qrpv)等指标.并对胆囊壁增厚的高频超声结果与门静脉系统血流动力学改变进行相关性分析.结果 经高频超声检测,4组患者的胆囊壁厚度差异具有统计学意义(P＜0.05);4组患者的Vpv、Dpv、Qpv之间均具有差异,差异具有统计学意义(P＜0.05);4组患者之间的Drpv及Qrpv差异无统计学意义(P＞0.05),仅Vrpv在组间有差异,差异具有统计学意义(P＜0.05);研究组与对照组Qrpv/Qpv比值差异无统计学意义(P ＞0.05);Dpv与胆囊壁增厚程度呈正相关(r =0.942,P＜0.05),Vpv和Qpv与胆囊壁厚度均负相关(r=-0.831,r=-0.927,P均＜0.05).胆囊壁厚度与Drpv、Vrpv及Qrpv之间无相关性(P＞0.05).结论 通过高频超声检测的胆囊壁增厚程度与肝硬化失代偿患者门静脉主干的血流动力学改变息息相关,而与门静脉右支的血流改变无关.%Objective To explore the analysis of the Correlation between the Degree of GBWT and Hemodynamic Changes of Portal Vein System.Methods A total 64 cases of Cirrhosis patients were divided into three groups:no thickening group,diffuse gallbladder wall thickening group and bilateral gallbladder wall thickening group.24 healthy volunteers were selected as the control group.Compare the Vpv,Dpv,Qpv,Vrpv,Drpv and Qrpv between the four groups.And analysis the Correlation between the Degree of GBWT and Hemodynamic Changes of Portal Vein System.Results There are Significant differences between the four groups of the Vpv、Dpv、Qpv (P ＜ 0.05);There are no significant differences between the four groups of the ratio of Qrpv/Qpv (P ＞ 0.05);There was good correlation between Dpv and the degree of gallbladder wall thickening(r =0.942,P ＜0.05).Vpv 和 Qpv were both negatively correlated with gallbladder wall thickness (r =-0.831,r =-0.927,respectively;both P ＞ 0.05).Conclusion These indicate that gallbladder wall thickening is closely related to hemodynamic parameters.It is feasible to predict the degree of portal hypertension through the observation of gallbladder wall thickening in patients with liver cirrhosis.