瞬时弹性成像技术对慢性肝病患者肝硬化程度及食管胃底静脉曲张破裂出血的预测研究

发布时间：2018-02-14 14:06

本文关键词： 肝病肝硬化食管和胃静脉曲张弹性成像技术　出处：《中国全科医学》2015年33期 　论文类型：期刊论文

【摘要】：目的利用瞬时弹性成像技术测量慢性肝病肝硬化患者肝硬度值及脾硬度值,评估不同Child-Pugh分级、食管胃底静脉曲张程度、出血情况慢性肝病肝硬化患者肝硬度值及脾硬度值的差异。方法选取2011年4月—2014年12月天津市第三中心医院住院的所有接受电子胃镜检查的慢性肝病肝硬化患者340例为研究对象,其中慢性乙型肝炎肝硬化患者170例,慢性丙型肝炎肝硬化患者35例,原发性胆汁性肝硬化患者46例,酒精性肝病肝硬化患者55例,自身免疫性肝炎肝硬化患者34例,分别检测血常规、凝血常规、肝功能、电子胃镜检查、腹部彩色多普勒超声以及进行瞬时弹性成像技术检查测量肝硬度值及脾硬度值。比较不同Child-Pugh分级、食管胃底静脉曲张程度、出血情况慢性肝病肝硬化患者肝硬度值及脾硬度值的差异。结果 Child-Pugh B级、Child-Pugh C级慢性乙型肝炎肝硬化、慢性丙型肝炎肝硬化、原发性胆汁性肝硬化、酒精性肝病肝硬化、自身免疫性肝炎肝硬化患者肝硬度值及脾硬度值高于Child-Pugh A级患者(P0.05);Child-Pugh C级各型慢性肝病肝硬化患者肝硬度值及脾硬度值高于ChildPugh B级患者(P0.05)。轻度静脉曲张、中度静脉曲张、重度静脉曲张各型慢性肝病肝硬化患者肝硬度值及脾硬度值高于无静脉曲张患者(P0.05);中度静脉曲张、重度静脉曲张各型慢性肝病肝硬化患者肝硬度值及脾硬度值高于轻度静脉曲张患者(P0.05);重度静脉曲张各型慢性肝病肝硬化患者肝硬度值及脾硬度值高于中度静脉曲张患者(P0.05)。单次出血、反复多次出血各型慢性肝病肝硬化患者肝硬度值及脾硬度值高于无出血患者(P0.05);反复多次出血各型慢性肝病肝硬化患者肝硬度值及脾硬度值高于单次出血患者(P0.05)。结论 Child-Pugh分级越高、食管胃底静脉曲张程度越重、出血情况越重慢性肝病肝硬化患者肝硬度值及脾硬度值越高;瞬时弹性成像技术可以有效地预测慢性肝病肝硬化患者肝硬化程度、食管胃底静脉曲张破裂出血的风险。
[Abstract]:Objective to evaluate the degree of esophageal and gastric varices in patients with chronic liver cirrhosis by measuring liver hardness and spleen hardness by transient elastic imaging. The difference of liver hardness and spleen hardness in patients with chronic liver cirrhosis methods all patients with chronic liver cirrhosis who received electronic gastroscopy from April 2011 to December 2014 were selected from Tianjin third Central Hospital. 340 cases were studied. There were 170 patients with chronic hepatitis B cirrhosis, 35 patients with chronic hepatitis C cirrhosis, 46 patients with primary biliary cirrhosis, 55 patients with alcoholic liver cirrhosis and 34 patients with autoimmune hepatitis cirrhosis. Blood routine examination, coagulation test, liver function, electronic gastroscopy, abdominal color Doppler ultrasound and instantaneous elastic imaging were used to measure the hardness of liver and spleen. The degree of esophageal and gastric varices, the degree of bleeding and the liver hardness and spleen hardness of patients with chronic liver cirrhosis were compared. Results Child-Pugh B grade C liver cirrhosis, chronic hepatitis C cirrhosis, primary biliary cirrhosis, liver cirrhosis, chronic hepatitis C, liver cirrhosis, chronic hepatitis C, liver cirrhosis, liver cirrhosis, liver cirrhosis, liver cirrhosis, liver cirrhosis, liver cirrhosis, and liver cirrhosis. The liver hardness and spleen hardness in patients with alcoholic liver cirrhosis and autoimmune hepatitis cirrhosis were higher than those in patients with Child-Pugh A and Child-Pugh C liver cirrhosis. The liver and spleen hardness of patients with moderate and severe varices were higher than those of patients without varicose veins (P 0.05). The hardness of liver and spleen in patients with severe varices was higher than that in patients with mild varices (P0.05), and the hardness of liver and spleen in patients with severe varices was higher than that in patients with mild varices. Patient Zhang P0.05. single bleeding, The value of liver hardness and spleen hardness in patients with various types of chronic liver cirrhosis were higher than those in patients without bleeding (P 0.05A), and the values of liver hardness and spleen hardness in patients with various types of chronic liver diseases with repeated repeated bleeding were higher than those in patients with single hemorrhage (P 0.05). The higher the Child-Pugh grade, The higher the degree of esophageal and gastric varices, the more severe the bleeding, the higher the hardness of liver and spleen in patients with liver cirrhosis, the higher the degree of liver cirrhosis in patients with chronic liver cirrhosis can be predicted by transient elastic imaging. Risk of bleeding from esophageal and gastric varices rupture.
【作者单位】：天津市津南区咸水沽医院内科;天津市第三中心医院消化内科;
【分类号】：R575.2

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