脾脏长径在无创性预测肝硬化高危食管曲张静脉出血中的临床价值

目的 研究门静脉、脾静脉内径和脾脏长径与肝硬化高危食管静脉曲张的关系及其临床价值.方法 回顾性分析望江县人民医院78例肝硬化合并食管静脉曲张住院患者的临床资料.出血组38例,非出血组40例.所有患者均行内镜确诊为食管静脉曲张.收集患者的一般资料、病因、Child-Pugh分值、肝功能生化指标（凝血酶原时间、白蛋白和胆红素水平）、是否出现腹水情况、是否有红色征,B超检测肝门静脉内径、脾静脉内径和脾脏直径.结果 两组间在红色征、肝门静脉内径、脾静脉内径和脾脏直径方面差异均有统计学意义（P均〈0.05）,出血组明显高于非出血组.结论 肝硬化食管静脉曲张破裂出血患者门静脉、脾静脉内径和脾脏长径明显增高,作为一种无创性检查指标,脾脏长径对于高危食管曲张静脉的诊断有一定的预测价值,有助于早期识别需行一级预防的肝硬化患者.

Clinical value of spleen diameter on noninvasive prediction of high-risk esophageal varices bleeding in patients with cirrhosis

Objective To study the relationship between the portal veins, splenic vein diameters, spleen diameter and high- risk esophageal varleeal bleeding in patients with cirrhosis and its clinical value. Methods The clinical data of 78 patients with esophageal variceal bleeding caused by cirrhosis were retrospectively analyzed. They were divided into two groups： bleeding group （38 cases） and non-bleeding group （40 cases）. All of the patients were confirmed with esophageal varices by endoscope. The patient~ general information, pathogenesis Child-Pugh score, liver function biochemical parameters （ prothrombin time, albumin and bilirubin levels）, aseites, red sign were collected, portal veins diameter, splenic vein diameter and spleen diameter were measured by type-B ultrasound. Results There were significant differences in red sign, the portal vein diameter, splenic vein diameter and spleen diameter between the two groups （ P 〈 0.05 ）. Conclusion The portal vein diameter, splenic vein diameter and spleen diameter in patients with esophageal varieeal bleeding is significantly higher. The spleen diameter can be used as a non-invasive predicor for high-risk esophageal varices is helpful for early recognize the patients with cirrhosis who need primary prevention.