彩超检测胃左静脉参数预测肝硬化胃底出血的价值

目的通过彩色多普勒测定胃左静脉内径、血流速度、血流量、血流方向等指标，探讨其预测食管静脉曲张出血风险的价值。方法肝硬化门静脉高压症86例，均接受彩色多普勒、电子胃镜及肝炎标志物、肝功能等检查，评价标准：随访24个月内经内镜检查确定为食道胃底静脉曲张破裂出血对比分析出血组与非出血组的胃左静脉血流动力学特点。结果胃左静脉呈离肝血流的患者中发生食管静脉破裂出血者多于向肝血流患者，差异有显著性意义（P〈0．01）；随着肝功能损害加重，胃左静脉内径呈增宽趋势，Child B、C级肝功能患者中，出血与非出血组间比较差异有显著性意义（P〈0．05）；在不同Child级别中，出血与非出血组患者在肝动脉血流峰速度（Vmax）、Q上无显著差异。结论彩色多普勒测定胃左静脉血流方向、内径能预测食管静脉曲张出血。

Value of blood stream dynamics detection in predicting esophageal variceal bleeding in patient with liver cirrhosis complicated by portal hypertension

Objective To determine left gastric vein(LGV) blood flow dynamics(vein diameter,blood flow speed,quantity,and direction) through colored Doppler sonography,and evaluate its value in predicting esophageal variceal bleeding in patient with liver cirrhosis complicated by portal hypertension.Methods in this series,86 patients with liver cirrhosis complicated by portal hypertension were examined by colored Doppler sonography,endoscope,and lab test for hepatitis markers and liver function.LGV blood flow dynamics characteristics were comparatively analysed between hemorrhage group and non-hemorrhage group.Results Patients with the blood stream of LGV away from the liver were more liable to esophageal variceal bleeding than those with the blood stream of LGV to the liver(P < 0.01).The inner diameter of the LGV had the tendency to widen along with the aggravation of the liver function impairment.In Child B and C patients,there was significant difference in the diameter between hemorrhage group and non-hemorrhage group(P < 0.05).In different Child ranks,there was no significant difference in the peak velocity of hepatic arterial flow(Vmax) and Q between hemorrhage and nonhemorrhage group.Conclusion The determination of blood flow direction and inner diameter of LGV through colored Doppler sonography can predict the risk of esophageal variceal bleeding.