肝豆状核变性合并脾大病人肝脾动脉血流动力学超声监测指标的临床价值
The value of ultrasound in monitoring the hemodynamics in hepatolenticular degeneration patients complicated with splenomegaly
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摘要: 目的：利用超声检查技术监测肝豆状核变性（HLD）合并不同程度脾大病人的肝、脾动脉血流改变情况，并探讨其临床价值。方法：应用彩色多普勒超声技术对25例HLD合并轻中度脾大（40 mm<脾脏厚径≤60 mm）病人（A组）和25例HLD合并重度脾大（脾脏厚径>60 mm）病人（B组）在空腹状态下的右肝动脉最大血流速度、脾门处脾动脉最大血流速度进行探测，并分析相关指标之间的相关性。结果：2组HLD病人脾脏厚度和右肝动脉、脾动脉流速呈现相关关系，并且重度脾大时，肝脾动脉最大流速在原本有所增加或减少的基础上升高或下降的更明显；2组HLD病人的右肝动脉、脾动脉流速差异均无统计学意义（P>0.05），B组脾脏厚度显著大于A组（P<0.01）。结论：对HLD合并不同程度脾大病人的肝动脉、脾动脉血流进行监测，可为临床对病人病情的监测及后期治疗提供参考，特别是为重度脾大病人行脾脏切除术提供了理论支持。Abstract: Objective:To observe the changes of hepatic and splenic arterial blood flow in hepatolenticular degeneration(HLD) patients complicated with splenomegaly using ultrasonography,and explore its clinical value.Methods:The maximum blood flow velocity of the right hepatic artery and splenic artery in 25 HLD patients complicated with mild to moderate splenomegaly(40 mm
60 mm)(group B) were detected using color Doppler ultrasonography under the fasting state,and the correlation among the relevant indicators was analyzed.Results:There was a positive correlation between the spleen thickness and flow velocity of the right hepatic artery and splenic artery in two groups,and the increasing or decreasing degree of the maximum flow velocity of the hepatic and splenic arteries were more obvious in group B.The differences of the right hepatic artery and splenic artery velocity between two groups were not statistically significant(P>0.05).The thickness of spleen in group B was significantly greater than that in group A(P<0.01).Conclusions:The monitoring hepatic artery and splenic artery blood flow in HLD patients complicated with different degrees of spleenomegaly can provide reference in monitoring disease and post-treatment,especially for splenectomy in patients with severe splenomegaly.
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