摘要
目的研究布加综合征患者介入手术治疗后,彩色多普勒超声技术在评价介入治疗疗效中的价值。方法应用彩色多普勒超声对48例下腔静脉支架置入术的布加综合征患者进行随访,比较其介入治疗前后肝脏、脾脏等的变化情况;统计分析48例布加综合征患者下腔静脉放置支架后,局部血栓的超声图像特点;根据患者是否使用抗凝剂分为原始剂量组(20例)和调整剂量组(28例),观察两组患者的血栓图像特点,根据图像特点来指导抗凝药物的使用;比较20例布加综合征患者肝静脉成行术前后,血管内径、血液流速的变化,并对上述指标进行相关的统计学分析。结果①下腔静脉支架置入术后肝脏、脾脏的彩超指标较术前有明显的改善;②介入治疗后彩色多普勒超声显示48例患者的下腔静脉内在疾病早期均有血栓,其中13例原始剂量组患者有血栓形成,而调整剂量组的患者仅4例有血栓形成,两组患者形成血栓的比率有统计学差异,提示调整剂量组的疗效明显好于原始剂量组。③肝静脉成形介入治疗后血流速度明显加快,血流速度由术前的(5.34±1.62)cm/s上升到介入治疗后的(16.57±1.43)cm/s,介入治疗前后的流速差异有显著的统计学意义(P<0.01);介入治疗前后血流速度之差与介入治疗前后肝静脉扩张程度之间呈高度的正相关(r=0.9701)。结论彩色多普勒超声可定性、定量的检测血流动力学指标,明确支架是否通畅,可作为布加综合征介入治疗后主要的随诊手段。在评价布加综合征介入治疗疗效及指导抗凝剂的应用方面具有独特的优势,是临床诊断布加综合征以及监测布加综合征治疗疗效的可靠手段。
Objective To study the effect and significance of application of ultrasonic technique in diagnosis and intervention treatment of patients with Budd - Chiari syndrome. Methods Forty eight patients with Budd - Chiari syndrome received intervention treatment were followed - up by color Doppler ultrasound. The conditions of color Doppler ultrasound of liver and spleen before and after treatment were compared. The characteristics of imaging for local thrombosis were described. These patients were divided into original dosage group and adjusted dosage group based on the application of anticoagulant agents. The characteristics of imaging of thrombosis were compared between these two groups in order to guide the treatment of anticoagulants. The inner diameter and blood velocity of hepatic vein before and after intervention therapy were compared. These indexes were statistically analyzed. Results (~)The ultrasound indexes of liver and spleen had been improved after intervention therapy. (~) The color Doppler ultrasound demonstrated the thrombosis had been presented in 48 patients in early stage after intervention therapy. Thrombosis was found in 13 patients of original dosage group; while thrombosis was found in 4 patients of adjusted dosage group. There was significant differ- ence in rate of occurrence of thrombosis in these two groups. The therapeutic effect of patients in adjusted dosage group was better than that of origi- nal dosage group. (~)The blood velocity of hepatic vein after intervention therapy was increased. The velocity of hepatic vein before therapy was 5. 34 ~ 1.62 cm/s and it changed to ( 16.57 ~ 1.43 ) cm/s. There was significant difference in blood velocity of hepatic vein. There was high posi- tive correlation between difference of blood velocity and diameter of hepatic vein before and after intervention treatment ( r = 0. 9701 ). Conclusion Color Doppler ultrasound can provide many indexes of real - time hepatic artery and vein changes, including qualitative and quantitative i
出处
《临床和实验医学杂志》
2013年第6期413-415,共3页
Journal of Clinical and Experimental Medicine
基金
2011首医基础-临床课题的支持(JL-21)
关键词
布加综合征
介入治疗
彩色多普勒
Budd Chiari syndrome
Intervention therapy
Color Doppler ultrasound