彩色多普勒超声对肝硬化患者门脉血流改变的评价

①目的探讨彩色多普勒超声检查对肝硬化患者门脉血流改变的临床意义。②方法用彩色多普勒起声对正常对照组（10例），代偿期肝硬化组（27例）和失代偿期肝硬化组（13例）患者门静脉内径、门静脉横截面积和血流速度分别进行检测。③结果代偿期肝硬化组、失代偿期肝硬化组组间的门静脉主干内径、门脉截面积、门脉充血指数是逐渐增加的，与对照姐比较有显著性差异；对照组、代偿期肝硬化组、失代偿期肝硬化组组间的门脉血流速度是逐渐减少的，与对照组比较有显著性差异；对照组、失代偿期肝硬化组组间以及代偿期肝硬化组、失代偿期肝硬化组组间的门脉血流量是下降的．与对照纽比较有显著性差异；失代偿期肝硬化并食管胃底静脉曲张、牌肿大肝硬化组门静脉与脾静脉血流速度、血流量两组比较有显著性差异。④结论多普勒超声为定量化评价肝脏血流变化提供了无创、简便的方法，能够获取门静脉血流动力学变化参数。对预示门静脉高压食管下段静脉曲张发生率及破裂出血有一定作用。对肝硬化门静脉高压的诊断、病情的发展、治疗效果的监测和预后评估具有重要的临床意义。

Evaluation of hemodynamic changes of portal veins in patients with liver cirrhosis by Color Doppler

Objective To explore hemodynamic changes of liver portal veins in patients with liver cirrhosis. Methods Internal diameter (mm), cross section area (cm2) and blood flow velocity (cm/s) of the portal vein were detected by color Doppler separately in 10 cases(control group), 27 cases with compensated liver cirrhosis(compensated group) and 13 cases decompensated liver cirrhosis (decompensated group). Results The internal diameter, cross section area and congestive index of liver portal vein increased, blood flow velocity and blood flow volume of liver portal vein decreased gradually from control group, compensated group to decompensated group , and there was significant difference among groups;The blood flow velocity and volume of spleen vein were higher than those of portal vein in the decompensated group with varices of esophagus and spleen, and difference was significant. Conclusions Color Doppler was used to evaluate liver hemodynamics quantitatively as a convenient and non-invasive method in the diagnosis, development, treatment and prognosis of portal vein hypertension, by which some hemodynamics parameters of portal vein could be acquired,and the occurrence rate of varices of esophagus and the possibility of rupture and bleeding of varices in liver portal vein hypertension were predicted.