彩色多普勒超声检测门脉血流参数对老年肝硬化门静脉高压症的诊断价值

目的:评价彩色多普勒超声对老年肝硬化门静脉高压症的诊断价值。方法 :对2009年1月-2011年12月老年肝硬化患者31例行腹部B超、增强CT,测量脾脏长径和厚度,使用彩色多普勒超声测定门静脉主干和门静脉流速,计算门静脉血流量,采用Child-Pugh分级标准进行肝功能分级,并行胃镜了解食管静脉曲张的程度。结果:老年肝硬化患者肝功能失代偿者明显增多,与非老年组患者比较差异有统计学意义。老年肝硬化伴门静脉高压症与不伴门静脉高压症患者比较门静脉内径增宽,血流速度下降,血流量减少,脾脏长径和厚度增加,但两组差异无统计学意义。结论:门静脉血流动力学变化对诊断老年肝硬化门静脉高压症具有一定的指导意义。

Diagnostic value of measuring portal hemodynamics by color Doppler ultrasonography in senile patients with liver cirrhosis and portal hypertension

Objective: To evaluate the diagnostic value of color Doppler ultrasound for portal hypertension in senile liver cirrhosis patients.Methods: From January 2009 to December 2012,the length and thickness of the spleens of 31 senior liver cirrhotic patients were measured using abdominal B ultrasound and enhanced CT.The inner diameters of their main portal vein and the flow rates of their portal veins were estimated using color Doppler ultrasound,and the portal venous flows were subsequently calculated.The patients were scored for liver function per the criteria for Child-Pugh classification.The extent of their esophageal varices was assessed using gastroscopy.Results: The study identified significantly more decompensated liver cirrhotic patients in the senior group than in the non-senior group,and the difference was statistically significant.However,the inner diameter of the portal vein,flow rate,portal venous flow,and spleen length and thickness were not significantly different between senior liver cirrhotic patients with and those without portal hypertension.Conclusion: The hemodynamic change of portal vein provides some meaningful guidance to the diagnosis of portal hypertension in senior liver cirrhotic patients.