彩色多普勒超声对肝硬化并门静脉高压预测食管静脉曲张出血的探讨

目的：用彩色多普勒超声检查门静脉和胃左静脉的管径、最大血流速度、血流量和血流方向，探讨它们与预测食管静脉曲张出血之关系。方法：肝硬化并门静脉高压伴重度食管静脉曲张和Ｃｈｉｌｄ－ｐｕｇｈＢ级患者６２例，其中出血组３０例和非出血组３２例。用多普勒超声分别测定两组之门静脉和胃左静脉的静脉径、最大血流速度、血流量和血流方向进行对比分析。结果：门静脉的上述参数在两组间无差异，但胃左静脉为离肝性血流者，出血组多于非出血组，差异非常显著（Ｐ＜０．０１）。随访一年，出血组发生再出血１０例（３３．３％），而非出血组发生首次出血６例（１８．７％）。但食管静脉曲张出血发生于胃左静脉为离肝性血流者在出血组为８０％，非出血组为８３．３％。结论：用彩色多普勒超声测定门静脉高压患者的胃左静脉为离肝血流时，对预测食管静脉曲张出血是有价值的

Prediction of EsophagealVariceal Bleeding with Color Doppler Sonographyin Patient with Liver Cirrhosis Complicated Portal Hypertension

Objective: To demonstrate hepatofugal left gastric vein(LGV)blood flow direction which provokes esophageal variceal bleeding in patient with liver cirrhosis complicated with portal hypertension. Methods: 62 patients consist of 30 with positive bleeding history,32 without previous bleeding all along.All the LGVs were tested by color Doppler sonography. Results: In a year long followup,10 cases of the former group had repeated bleedings occurred,6 cases of the latter group had once the event. Conclusion: Liver cirrhosis complicated portal hypertension patients with hepatofugal LGV flow demonstrated by color Doppler songoraphy had a greater variceal bleeding tendency than those without.