探讨超声在酒精性肝硬化与肝炎后肝硬化中的诊断及鉴别诊断价值

目的 探究对酒精性肝硬化患者和肝炎后肝硬化患者实施超声诊断的效果。方法 随机抽取92例肝硬化患者为观察对象,结合临床最终诊断结果将其分为酒精性肝硬化组(42例)和肝炎后肝硬化组(50例)。对所有患者均实施超声检查,对比超声检查效果及超声表现。结果 (1)经超声检查显示,酒精性肝硬化误诊4例、肝炎后肝硬化误诊2例,一致性检测显示Kappa值为0.856。(2)在诊断酒精性肝硬化和肝炎后肝硬化方面,超声的敏感度、特异度、总准确率分别为92.00%、95.24%、93.48%。(3)酒精性肝硬化患者肝脏形态异常、不规则回声增强、肝被膜锯齿状所占比显著低于肝炎后肝硬化,但弥漫性回声增强所占比较肝炎后肝硬化更高(P0.05);而两组腹水所占比无显著差异(P0.05)。(4)酒精性肝硬化患者脾脏厚度较肝炎后肝硬化更小,但肝右叶肋下斜径、肝左叶厚径较肝炎后肝硬化更大(P0.05),而两组门静脉内径无显著差异(P0.05)。结论 对酒精性肝硬化和肝炎后肝硬化患者实施超声诊断具有较好的效果,可行性较高。

Investigations of the diagnostic and differential diagnostic value of ultrasound for the alcoholic cirrhosis and post-hepatitis cirrhosis

Objective To investigate the efficacy of ultrasonic diagnosis for patients with alcoholic cirrhosis and those with post-hepatitis cirrhosis.Methods 92 patients with liver cirrhosis were randomly selected as observation objects and divided into the alcoholic cirrhosis group(n=42) and the post-hepatitis cirrhosis group(n=50) according to clinical final diagnosis.All patients were examined by ultrasound,and the results and manifestations of ultrasound were compared.Results (1)Ultrasonic examination showed that 4 cases of alcoholic cirrhosis and 2 cases of posthepatitic cirrhosis were misdiagnosed,and consistency examination showed Kappa value was 0.856.(2)In the diagnosis of alcoholic cirrhosis and post-hepatitis cirrhosis,the sensitivity,specificity and total accuracy of ultrasound were 92.00%,95.24% and 93.48% respectively.(3)The proportion of abnormal liver morphology,irregular echo enhancement and serration of liver capsule in patients with alcoholic cirrhosis was significantly lower than that in patients with post-hepatitis cirrhosis,but the proportion of diffuse echo enhancement was higher than that in patients with post-hepatitis cirrhosis (P<0.05).However,there was no significant difference in the proportion of ascites between the two groups(P>0.05).(4)The spleen thickness of patients with alcoholic cirrhosis was smaller than that of patients with post-hepatitis cirrhosis,but the subcostal oblique diameter of the right lobe of the liver and the thickness diameter of the left lobe of the liver were larger than those of patients with post-hepatitis cirrhosis(P<0.05),while there was no significant difference in portal vein diameter between the two groups(P>0.05).Conclusion Ultrasonic diagnosis for alcoholic cirrhosis and post-hepatitis cirrhosis is effective and feasible.