彩色多普勒超声在肝硬化门脉高压中的临床应用价值
[摘要] 目的 分析彩色多普勒超声对肝硬化门脉高压患者的临床诊断价值。方法 方便抽选2015年11月—2017年1月该院接收的68例肝硬化门脉高压患者，将其作实验组；同时选同期68名健康体检者，将其作参照组；对2组均行彩色多普勒超声诊断，比对2组脾静脉、门静脉血流动力学、血流量比值改善情况。结果 实验组脾静脉内径值（1.05±0.16）cm，门静脉内径值（1.48±0.18）cm，均优于参照组（0.81±0.21）、（1.21±0.19）cm，差异有统计学意义（P<0.05）；实验组血流量比值（0.48±0.08），比参照组（0.27±0.10）高，（P<0.05）；实验组脾静脉内径超过1.0 cm、门静脉内径超过1.4 cm患者，重度食管胃底静脉曲张所占比例43.59%、40.54%，均比低于1.0 cm、低于1.4 cm患者所占比例20.69%、12.90%高，（P<0.05）。结论 临床对肝硬化门脉高压患者展开专业诊断时，予以彩色多普勒超声诊断，可在准确评估患者脾静脉、门静脉血流动力学水平的基础上，增加血流量比对。
[关键词] 彩色多普勒超声；肝硬化门脉高压；临床价值
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2018）01（c）-0012-03
[Abstract] Objective This paper tries to evaluate the clinical value of color Doppler ultrasonography in the diagnosis of portal hypertension in patients with liver cirrhosis. Methods 68 patients with cirrhotic portal hypertension received from November 2015 to January 2017 were conveient selected as the experimental group. 68 healthy subjects were selected as the control group. All the two groups underwent color Doppler ultrasonography and were observed at the same time. Compared with the two groups， the ratio of splenic vein， portal vein hemodynamics and blood flow improved condition. Results The diameter of the splenic vein （1.05±0.16）cm and the portal vein diameter （1.48±0.18） cm， were significantly higher than those in the control group （0.81±0.21）cm， （1.21±0.19）cm， with significant difference（P<0.05）. The blood flow ratio （0.48±0.08） in the experimental group was higher than that in the control group （0.27±0.10） （P<0.05）. In the experimental group， the diameter of the splenic vein was more than 1.0 cm， the portal vein diameter was more than 1.4 cm， the proportion of varicose veins was 43.59% and 40.54%， respectively， which were lower than 1.0 cm， and the proportion of patients with less than 1.4 cm was 20.69% and 12.90%， respectively（P<0.05）. Conclusion Color Doppler ultrasonography can be used to diagnose the hemodynamics of splenic vein and portal vein in patients with cirrhotic portal hypertension. The blood flow ratio comparison is increased.
[Key words] Color Doppler ultrasound； Cirrhosis of the portal hypertension； Clinical value
引發肝硬化门脉高压疾病的危险因素较多，主要因门静脉血液严重瘀滞，如若门静脉压力比常规值高，就会致使侧支循环开放，从而伴发各种临床症状，如脾功能亢进、腹水、食管胃底静脉曲张等，若病情发展较严重，则会伴发胃底、食管静脉曲张破裂严重出血[1]。临床对于肝硬化门脉高压患者，比较常规的做法就是依靠胃镜进行检出，但是该种检出方法大多数患者难以接受，尽管胃镜检查能够明显、清晰的发现静脉曲张，但也很难准确的预测患者出血的具体部位及出血量所少等。将彩色多普勒超声应用在门静脉高压及肝硬化患者的临床诊断中，操作方法非常简单，操作起来较简便，且创伤非常小，实用性、经济性较高，患者便于接受。为此，对肝硬化门脉高压患者展开安全、高效的诊断，对后续临床治疗工作的开展及预后具有积极作用。为评估彩色多普勒超声对肝硬化门脉高压患者的临床诊断价值，该次研究对象为方便选取2015年11月—2017年1月收治的68例肝硬化门脉高压患者及68名健康体检者，现将临床诊断结果展开如下报道。