肝硬化患者腹腔镜胆囊切除术前彩色多普勒超声应用价值

目的探讨彩色多普勒超声在肝硬化患者腹腔镜胆囊切除术（Laparascopic cholecystectomy，LC）术前的应用价值。方法肝硬化胆石症纽35例．依据肝功能Child-Pugh分级标准分为3个亚组，正常对照组20例。运用彩色多普勒超声检测门脉系血管，测量门静脉最大内径、门静脉平均血流速度等血流动力学参数。结果门静脉平均血流速度随肝功能分级而逐渐降低，组间和组内均存在显著性差异（P〈0．01，P〈0．05）；门静脉内径组间存在差异（P〈0．05），组内无显著性差异；除脐静脉重开外，其余门脉系血管内径增粗在Child-Pugh分级B、C二级存在较大重叠。结论彩色多普勒有助于全面评估门静脉压力和门脉侧支开放及代偿情况，为筛选LC手术病人提供重要依据。

Application of color Doppler flow imaging before laparoscopic cholecystecomy in patients with liver cirrhosis

Objective To investigate the value of color Doppler flow imaging （CDFI） before laparoscopic cholecystecomy in patients with liver cirrhosis. Methods The 35 gallstone patients with liver cirrhosis of Child-Pugh A,B and C subgroups, The diameter of portal vein and mean velocity of blood flow in portal vein were measured with CDFI and 20 healthy subjects were examined with CDFI. Results The mean velocity portal venous flow in liver cirrhosis patients decreased and there were significant differences between liver cirrhosis group and the control group（P〈0.01） and subgroups of Child-Pugh A,B and C（P〈0.05）. The diameter of main portal vein was increased in patients with liver cirrhosis, There were significant differences between liver cirrhosis group and the control group, no significant differences between groups of Child-Pugh A, B and C. There was overlap of portal venous diameter between Child-Pugh B and C group except the reopen of umbilical vein. Conclusion CDFI is helpful in the evaluation of portal hypertension and branches of portal vein, which is valuable in the selection of patients for laparascopic cholecystectomy.