摘要
目的比较多层螺旋CT门静脉造影(MSCTP)三维重建技术和B超门静脉血流动力学检查对食管静脉曲张出血(EVB)预测的准确性。方法收集60例同时行MSCTP和B超检查的肝硬化患者的临床资料,记录其实际出血的患者例数。根据胃左静脉(LGV)>0.61 cm和门静脉血流量(PBF)>1098.36 ml/min为预测出血的标准,记录两种方法预测出血的实际发生例数。根据预测出血例数/实际出血例数,分别计算两种方法对出血的检出率,并比较MSCTP和B超检查与胃镜检查结果的一致性。结果在60例患者中实际出血28例;LGV>0.61cm对出血的检出率为89.29%,PBF>1098.36 ml/min的检出率为60.71%,说明分别以MSCTP和B超检查对出血的检出率差异有统计学意义(x2=6.095,P=0.029);在28例实际出血的患者中,通过胃镜检查发现有静脉曲张出血26例,未发现出血2例;采用Mc Nemar检验发现,MSCTP与胃镜检查对EVB预测结果的差异无统计学意义(P=1.000);采用Kappa系数法分析,显示这两种方法的吻合度差异具有显著性(吻合系数K=0.781,P=0.000);B超与胃镜检查对EVB预测结果的差异具有统计学意义(P=0.012),采用Kappa系数法分析,显示这两种方法的吻合度差异无显著性(吻合系数K=0.038,P=0.747)。结论 MSCTP对预测EVB有更好的检出率,并且MSCTP与胃镜检查结果具有较高的一致性,因而对EVB具有重要的预测价值。
Objective To evaluate the accuracy of predicting esophageal variceal bleeding （EVB） in pa- tients with liver cirrho：sis with three-dimensional reconstruction by multi-slice spiral CT portography （MSCTP） and hemodynamic determination of portal vein by B uhrasonography. Methods The clinical data of 60 patients with cirrhosis who were simultaneously examined by MSCTP and B ultrasonography were collected in this study. The gastroscopy was conducted in patients with EVB. Results In 60 with liver cirrhosis, the actual number of bleeding was 28. When LGV〉0.61 cm and PBF〉1098.36 ml/min were determined as the cut-off value for EVB, the accurate rates by MSCTP and uhrasonography were 89.29% and 60.71%, respectively （x2=6.095,P=0.029）;26 out of 28 patients with EVB was confirmed by gastroscopy, and no esophageal varices bleeding in the other 2 cases;MSCTP and gastroscopy had no significant difference in predicting EVB （P=I.000） as determined by McNe- mar test,and Kappa coefficient analysis showed substantial consistency of these two methods （matching coefficient K=0.781,P=0.000）;While there was a significant difference between uhrasonography and gastroscopy in predicting EVB（P=0.012）,and Kappa coefficient analysis showed slight consistency of these two methods （matching coeffi- cient K=0.038,P=0.747）. Conclusion MSCTP can predict EVB,and has a good consistency with gastroscopy.
出处
《实用肝脏病杂志》
CAS
2015年第1期47-50,共4页
Journal of Practical Hepatology
基金
延安大学附属医院研究生创新基金项目(编号:10YJ11)
