血吸虫病肝硬变患者肝段下腔静脉内径的超声研究

目的探讨血吸虫病肝硬变患者硬变肝段下腔静脉内径的变化，了解肝硬变程度与肝段下腔静脉内经变化的关系。方法对92例血吸虫病肝硬变患者和36例健康志愿者（对照组）行超声检查，平静呼吸状态下及深吸气后测量肝段下腔静脉最大横断面的长轴、短轴及其最大横截面积。结果健康对照组的肝段下腔静脉在深吸气后与平静呼吸状态下比较最大横断面的长轴、短轴及其最大横截面积差异均有非常显著性（t=21.16，P〈0.01;t=19.28，P〈0.01;t=17.78，P〈0.01）。肝硬变组的肝段下腔静脉在深吸气后与平静呼吸状态下比较最大横断面的长轴、短轴及其横截面积在肝硬变A级（按Child-Pugh分级）差异有非常显著性（t=19.87，P〈0.01;t=16.78，P〈0.01;t=17.96，P〈0.01），B级差异有显著性（t=5.73，P=0.0214;t=4.96，P=0.035;t=5.21，P=0.029），C级差异无显著性（t=1.72，P=0.297;t=1.24，P=0.236;t=1.94，P=0.372）。结论肝硬变患者肝段下腔静脉横断面的长轴、短轴及其横截面积在深吸气后与平静呼吸状态下的变化随着肝硬变的程度增加逐渐变小。

Ultrasonic study on diameter changes of the inferior vena cava in liver segments of the patients with schistosomiasis liver cirrhosis

Objective To study the diameter changes of the inferior vena cava(IVC) in the liver cirrhosis segments of the patient having schistosomiasis cirrhosis,and to study the relationship between the seriousness degree of liver cirrhosis and the diameter change of the IVC.Methods The ultrasonic examinations conducted on ninety-two patients with schistosomiasis liver cirrhosis and 36 volumter with normal livers as the control group,and the major axis,minor axis and area of the IVC were measured during normal breathing and deep inspiration according to Child-Pugh classification. Results The examination show that for the healthy contrast group,there is significant different between normal breathing and deep inspiration in terms of the major axis,minor axis and maximum area of the IUC(t=21.16,P<0.01;t=19.28,P<0.01;t=17.78,P<0.01).However,for the schistosomiasis liver cirrhosis patient group,there was significant difference between normal breathing and deep inspiration in terms of the major axis,minor axis and maximum area of the IVC for class A(t=19.87,P<0.01;t=16.78,P<0.01;t=17.9,P<0.01)and class B(t=5.73,P=0.0214;t=4.96,P=0.035;t=5.21,P=0.029).But,there was no significant difference was observed in these parameters for class C(t=1.72,P=0.297;t=1.24,P=0.236;t=1.94,P=0.372).Conclusion The parameters of the two axes and maximum areas of IVC in cirrhotic patient decrease gradually with the seriousness degree of cirrhosis increase after deep inspiration or normal breathing.