摘要
目的观察术前CT/MRI检查门静脉系统指标预测肝硬化脾切除术后门静脉血栓形成(PVT)的价值。方法 2016年7月～2018年7月我院收治的87例乙型肝炎肝硬化脾切除术后患者接受CT和MRI检查,随访3个月,观察PVT发生率,采用多因素Logistic回归分析肝硬化脾切除术后PVT形成的独立影响因素。结果在随访3个月末,在87例肝硬化脾切除术后患者发现PVT者46例(52.9%),均为PVTⅠ级,门静脉附壁血栓45例(51.7%),其中伴肠系膜上静脉附壁血栓14例(16.1%);46例PVT组门静脉直径为(16.7±2.2) mm,显著大于41例非PVT组【(14.8±1.5) mm,P<0.05】,门静脉流速差为(8.4±5.5) cm/s,显著高于非PVT组【(6.1±3.6) cm/s,P<0.05】,脾容积为(1370.8±370.1) cm^3,显著大于非PVT组【(1205.2±357.3) cm^3,P<0.05】;多因素Logistic回归分析显示,门静脉直径(OR=0.869,95%CI=0.608～1.246)、门静脉流速差(OR=1.185,95%CI=1.079～1.317)和脾容积(OR=3.427,95%CI=2.215～5.302)均是肝硬化脾切除术后PVT形成的独立影响因素(P<0.05)。结论术前CT/MRI检查指标可以预测肝硬化脾切除术后PVT形成,及时处理和预防将改善患者预后。
Objective The aim of this study was to investigate the predictive value of preoperative CT/MRI indicators for portal vein thrombosis(PVT) in patients with liver cirrhosis after splenectomy. Methods 87 patients with hepatitis B liver cirrhosis after splenectomy were retrospectively analyzed in our hospital between July 2016 and July 2018,and all patients were followed-up and underwent CT and MRI check-up. Multivariate logistic regression analysis was applied to predict the independent influencing factors of PVT formation after splenectomy. Results At the end of three-month follow-up,46 patients (52.9%) had PVT out of the 87 patients with cirrhosis,belonging to typeⅠPVT,and mural thrombus was found in 45 patients(51.7%),out of which,14(16.1%) as mural thrombus in superior mesenteric vein;the diameter of portal vain in 46 patients with PVT was(16.7±2.2)mm,significantly wider than 【(14.8±1.5) mm,P<0.05】 in 41 patients without PVT,the difference of portal vein velocity was (8.4±5.5) cm/s, significantly rapider than [(6.1±3.6) cm/s,P<0.05] in non-PVT group and the spleen volume was (1370.8±370.1) cm3,significantly larger than [(1205.2±357.3) cm^3,P<0.05] in non-PVT group;multivariate logistic regression analysis showed that the diameter of portal vein(OR=0.869,95%CI=0.608-1.246),the velocity difference of portal vein(OR=1.185,95%CI=1.079-1.317),and the spleen volume(OR=3.427,95%CI=2.215-5.302) were the independent influencing factors of PVT formation after splenectomy in patients with cirrhosis (P<0.05). Conclusion Preoperative CT/MRI diagnostic indexes such as portal vein diameter,portal vein velocity difference and spleen volume are independent influencing factors of PVT formation after splenectomy for liver cirrhosis.
作者
肖科
潘志华
涂波
陈丽
Xiao Ke;Pan Zhihua;Tu Bo(Department of Radiology,Second Affiliated Hospital,Chengdu Medical College,Chengdu 610051,Sichuan Province,China)
出处
《实用肝脏病杂志》
CAS
2019年第3期417-420,共4页
Journal of Practical Hepatology
基金
四川省卫生与健康委员会科研基金项目(编号:2010100183)
