超声检查附脐静脉开放腹壁静脉曲张在门静脉高压临床分型的意义

目的应用彩色多普勒超声对门静脉高压附脐静脉开放和腹壁静脉曲张门腔之间侧支循环进行研究,确定门脉高压分型。方法超声检查86例肝硬化门静脉高压、13例布加综合征及6例门静脉主干、脾静脉血栓3组门静脉高压患者的腹壁静脉曲张门腔之间侧支循环吻合情况及血流方向。结果肝硬化门静脉高压组腹壁静脉曲张在脐以上血流流向头端,而脐以下血流流向腹端。布加综合征合并下腔静脉阻塞组,血流均流向上胸端。门静脉主干、脾静脉血栓未见脐静脉开放及腹壁静脉曲张。结论应用彩色多普勒超声判断附脐静脉开放和腹壁静脉曲张门腔之间侧支循环的情况,可明确血管阻塞部位、程度、范围,为肝前、肝内及肝后门静脉高压分型的诊断提供有效依据,对临床制定合理治疗方案具有指导意义。

Color Doppler sonography features of patent paraumbilical veins and abdominal varicose veins in portal hypertension classification

Objective To study the patent paraumbilical veins and abdominal varicose veins in portal hypertension by color Doppler ultrasound, and to establish the classification of portal hypertension. Methods Three groups of patients with portal hypertension, including 86 cases of liver cirrhosis, 13 cases of Budd-Chiari syndrome and 6 cases of portal vein trunk or splenic vein thrombosis were examined by color Doppler ultrasound, abdominal varicose veins of portaeaval collateral circulation and blood flow direction were observed. Results In liver cirrhosis group, the blood flow direction of abdominal varicose veins was towards the head above the navel, while towards the feet below the navel. In Budd - Chiari syndrome combined with IVC obstruction group, blood flow direction was toward the upper chest area. In portal trunk or splenic vein thrombosis group, the patent umbilical vein and abdominal varicose veins werent seen. Conclusion Determination of patent paraumbilical veins and abdominal varicose veins by ultrasound can help to identify the location, degree and scope of vascular occlusion, which provids efective method for classification of portal hypertension and has significance for formulation of reasonable treatment plan.