多排螺旋CT在预测门静脉高压致上消化道大出血中的临床价值

目的用多排CT测量门静脉系血管内径大小,从而评估其在预测门静脉高压致上消化道大出血中的临床价值。资料与方法将门静脉高压患者分为上消化道出血组和未出血组,所有患者行64排螺旋CT增强扫描,以获取两组患者的门静脉、脾静脉、胃冠状静脉、食管胃底曲张静脉的直径,再将各血管直径分为不同等级资料,分别用方差分析两组间差异性、卡方分析不同等级资料间的差异性及各等级资料的出血患者百分比例、Logistic回归分析各血管在出血中的独立危险因素。结果两组患者的门静脉、胃冠状静脉、食管胃底曲张静脉直径之间有显著差异性(P<0.05);各等级资料间有明显差异性(P<0.05),当门静脉宽度≥18 mm、胃冠状静脉宽度≥8 mm、食管胃底曲张静脉宽度≥6 mm时出血的比例明显增加;胃冠状静脉、食管胃底曲张静脉宽度在该出血中是独立危险因素。结论门静脉、胃冠状静脉、食管胃底曲张静脉的直径在预测上消化道出血中有明显意义。

The Clinical Value of MSCT in Forecasting the Upper Gastrointestinal Hemorrhage Caused by Portal Hypertension

Objective To investigate the clinical value of MSCT in forecasting the upper gastrointestinal hemorrhage caused by portal hypertension.Materials and Methods All the patients with portal hypertension received 64 slice CT enhanced scan,then patients were divided into bleeding group and no bleeding group.The diameter of portal vein,gastric coronary vein,spleen vein and gastroesophageal varices were measured,then the data were divided into three different grades.F test was used to detect the difference of the diameter of the two group,x2 test was used to detect the difference of the three grades,Logistic regression analysis was used to reveal the independent risk factor in all the blood vessel.Results There was difference between the diameter of the two groups,and also significant difference existed in the three grades,the percent of the patient with upper gastrointestinal hemorrhage were significantly increased when the diameter of portal vein,gastric coronary vein,gastroesophageal varices was more than or equal to 18 mm,8 mm and 6 mm respectively.Gastric coronary vein and gastroesophageal varices were the independent risk factors in the upper gastrointestinal hemorrhage.Conclusion There is significant value of the diameter of portal vein,gastric coronary vein and gastroesophageal varices in forecasting the upper gastrointestinal hemorrhage of portal hypertension.