超声下胃左静脉指标在肝硬化食管静脉曲张破裂出血预测中的应用

摘要

Objective To evaluate the predictive value of the measuring index of left gastric venous in patients with liver cirrhosis and esophageal variceal bleeding .Methods The change of left gastric vein and esophageal varices in 80 pa-tients with liver cirrhosis and portal and 35 normal controls were observed by color Doppler sonography ,and statistical analy-sis the max inner diameter ,shunt index of left gastric vein .Results Compared with the control group ,the diameter of left gastric vein widened obviously in portal hypertension group , hemorrhage group was significantly higher than that in non bleeding group and the control group (P<0.01).shunt index of left gastric vein in hemorrhage group was significantly higher than that in non bleeding group and the control group .Non bleeding group was significantly higher than the control group.The maximum diameter of the left gastric vein for 6.5mm as bleeding prediction standard , predicting bleeding speci-ficity, sensitivity and accuracy were 78.3%, 73.5%, 76.3%.The left gastric vein shunt index is scheduled for 0.13, predict bleeding specificity , sensitivity and accuracy were 82.5%, 76.3%, 69.8%.Conclusion the max inner diameter and shunt index of left gastric vein are helpful for predicting gastroesophageal varices and variceal hemorrhage in Cirrhosis patients.%目的：评价超声下胃左静脉指标测量在肝硬化食管胃底静脉破裂出血预测中的应用价值。方法对80例肝硬化门静脉高压患者（出血组34例，未出血组46例）和35例健康志愿者（对照组）行彩色多普勒超声检查，观察胃左静脉以及食管胃底静脉曲张情况，计算胃左静脉最大内径及胃左静脉分流指数。结果与对照组比较，门脉高压患者胃左静脉最大内径增宽，其中出血组胃左静脉最大内径大于未出血组及对照组（P＜0．01）。以胃左静脉最大内径6．5 mm为出血预测标准，预测出血的特异性、敏感性和准确性分别为78．3％、73．5％、76．3％。胃左静脉分流指数截断值定于0．13时，预测出血的特异性、敏感性和准确性分别为82．5％、76．3％、69．8％。结论超声检查测量胃左静脉最大内径及胃左静脉分流指数有助于预测肝硬化食管胃底静脉破裂出血。