摘要
目的探讨16层螺旋CT扫描的胰源性门静脉高压(PSPH)患者门静脉及其侧支循环的特征。方法回顾性分析2016年4月-2018年4月本院收治并确诊为PSPH的58例患者的临床资料。所有患者均采用16层螺旋CT进行扫描,依据脾静脉、门静脉和肠系膜上静脉的情况分为孤立性脾静脉阻塞(ISVO)组和非孤立性脾静脉阻塞(NISVO)组,比较两组患者静脉曲张情况和侧支循环通路分型之间的差异。结果 58例患者中,食管下段静脉曲张1例(1. 72%),胃底静脉曲张11例(18. 97%),胃冠状静脉曲张23例(39. 66%),胃短静脉曲张22例(37. 93%),胃网膜静脉曲张54例(93. 10%),胰周静脉曲张3例(5. 17%)。ISVO组胃底静脉、胃冠状静脉和胃短静脉曲张的比例显著低于NISVO组(P <0. 05,P <0. 01)。58例患者中,以Ⅰ型和Ⅲ型侧支循环通路者为主,Ⅱ型者较少。两组患者侧支循环通路分型之间比较,差异有统计学意义(P <0. 05),ISVO组Ⅰ型比例高于NISVO组,Ⅱ型和Ⅲ型比例低于NISVO组。结论 PSPH患者以胃网膜静脉曲张最为多见,NISVO患者发生胃底静脉、胃冠状静脉和胃短静脉曲张的风险高于ISVO患者,而且PSPH的侧支循环以Ⅰ型和Ⅲ型循环通路为主。
Objective To analyze the characteristics of portal vein and its collateral circulation in patients with pancreatic portal hypertension( PSPH) on 16-slice spiral CT. Methods The clinical data of 58 patients with PSPH admitted to our hospital from April 2016 to April 2018 were retrospectively analyzed. All patients were scanned with 16-slice spiral CT.According to the condition of splenic vein,portal vein and superior mesenteric vein,they were divided into isolated splenic vein occlusion( ISVO) group and non-isolated splenic vein occlusion( NISVO) group. The two groups were compared in terms of varicosity and collateral circulation pathway. Results Among the 58 patients,there was 1 case of lower esophageal varices( 1. 72%),11 cases of gastric varices( 18. 97%),23 cases of gastric coronary varices( 39. 66%),22 cases of short gastric varices( 37. 93%),54 cases of gastroepiploic varices( 93. 10%) and 3 cases of peripancreatic varices( 5. 17%).The proportion of gastric varices in ISVO group was significantly lower than that in NISVO group( P < 0. 05,P < 0. 01). The majority of them belonged to type Ⅰ and type Ⅲ collateral circulation pathways,and there were a few type Ⅱ. There was significant difference in collateral circulation pathway classification between the two groups( P < 0. 05). The proportion of typeⅠ in ISVO group was higher than that in NISVO group,and the proportion of type Ⅱ and type Ⅲ was lower than that in NISVO group. Conclusion Gastroesophageal varices are the most common type in PSPH patients. The risk of gastric varices in NISVO patients is higher than that in ISVO patients. The collateral circulation of PSPH mainly belongs to types Ⅰ and Ⅲ.
作者
郑勇平
汪立娟
陈健群
ZHENG Yongping;WANG Lijuan;CHEN Jianqun(Longgang Second People's Hospital,Shenzhen 518112,China)
出处
《现代医院》
2020年第5期772-774,共3页
Modern Hospitals
基金
深圳市龙岗区科技计划项目(20160607155613210)。
关键词
多层螺旋CT
区域性门静脉高压
胰源性
侧支循环
静脉曲张
Multi-slice spiral CT
Regional portal hypertension
Pancreatic origin
Collateral circulation
Varicose veins
