彩超下肝硬化门脉血流动力学改变与食管静脉曲张破裂出血的关系研究

目的探讨肝硬化时门脉血流动力学改变与食管静脉曲张破裂出血(EVB)的关系,寻求预测EVB的方法。方法用彩色多普勒超声测定正常人(A组)、肝硬化-无食管静脉曲张(B组)、肝硬化-食管静脉曲张无出血(C组)和肝硬化-食管静脉曲张合并出血(D组)4组,患者门静脉血管内径、血流速度、血流量3个血流动力学参数,对4组数据进行对比分析。结果与A组正常人比较,肝硬化3组患者门静脉内径明显增宽(P<0.01),血流量明显增加(P<0.05),血流速度明显减慢(P<0.01)。D组与B、C组相比,门静脉血流速度有显著性增加(P<0.05)。结论门静脉血流速度减慢与EVB的发生有关,动态监测门静脉血流速度的变化可望成为预测EVB发生的有效手段。

A Study on Relations between Esophageal Variceal Bleeding and Portal Vessel Hemodynamic Changes under Color Doppler Ultrasound in Cirrhosis

Objective To investigate the relation between esophageal variceal bleeding(EVB)and the portal vessel hemodynamic changes in cirrhosis,and seek ways to forecast EVB by color Doppler ultrasound.Methods Normal people and cirrhotic patients were enrolled and were divided into four groups:normal control group(group A),cirrhosis without esophageal varices group(group B),cirrhosis-esophageal varices without EVB group(group C)and cirrhosis-esophageal varices with EVB group(group D).The color Doppler ultrasound technology was used to detect hemodynamic parameters of the portal vessels including diameter,blood flow velocity,blood flow volume,and these parameters were statistically analyzed.Results The diameters of portal vessel,blood flow volume and blood flow velocity in three cirrhosis groups were significantly larger or faster than that in normal control group(group A).Within the three cirrhosis groups,blood flow velocity in group D were significantly slower than the other two groups(P<0.05).Conclusion The slower pace of portal blood flow has relation to the occurrence of EVB.Dynamic detection of portal blood flow velocity changes is expected to become an effective mean to forecast EVB.