彩色多普勒超声在Budd－Chiari综合征的诊断价值.DOCVIP

临床医学论文-彩色多普勒超声在Budd－Chiari综合征的诊断价值 【摘要】??目的：探讨BuddChiari综合征(B-CS)的特征性异常血管形态及其血流的变化。方法：对85例B-CS患者的肝静脉、下腔静脉，进行彩色多普勒超声分析。结果：85例B－CS其下腔静脉狭窄52例，闭塞9例；肝静脉狭窄102支，闭塞61支，其肝静脉间均见多条侧支血管；肝静脉血流经侧支血管流入未闭的肝静脉或经肝尾叶静脉及其他扩张的静脉分流入下腔静脉；下腔静脉闭塞时血流亦可逆向分流入肝静脉。结论：肝静脉、下腔静脉狭窄和闭塞及肝静脉间侧支血管形成是B－CS特征性异常血管形态；彩色多普勒超声可依据其特征性异常血管的病变类型、阻塞部位、梗阻程度和范围、侧支循环径路及血流动力学特点准确诊断B－CS，并作为首选检查方法。? 【关键词】??布－卡氏综合征?彩色多普勒超声?血流动力学 　　The?Diagnostic?Value?of?Color?Doppler?Ultrasonography?in?BuddChiari?Syndrome 　　????Abstract:Objective?To?investigate?the?characteristically?abnormal?vascular?sharps?in?BuddChiari?syndrome?(B-CS),and?the?changes?of?blood?flow.Methods??The?hepatic?veins?and?inferior?cave?veins?of?85?B-CS?patients?were?evaluated?with?color?Doppler?ultrasonography.Results?In?the?85?B-CS?patients,52?had?narrowed?and?9?had?closed?inferior?vena?cava;102?hepatic?veins?were?found?narrowed?and?61?closed?with?several?collateral?blood?vessels?through?which?some?hepatic?venous?blood?flowed?to?the?unclosed?hepatic?veins,some?hepatic?venous?blood?shunted?through?hepatic?sinistrae?veins?or?other?enlarged?veins?into?inferior?vena?cave.In?the?cases?of?closed?inferior?vena?cave,the?blood?in?inferior?vena?cava?can?alsoreshunt?to?hepatic?veins.Conclusion?Narrowed?or?closed?inferior?vena?cave?and?collateralvessel?formation?are?characteristic?abnormal?vascular?sharps?in?B-CS;with?color?Doppler?ultrasonography,which?should?be?used?as?the?firstchoosing?examination,accurate?diagnosis?can?be?made?based?on?its?characteristic?abnormal?vascular?changes?such?as?types?of?abnormal?vessel,blocking?location,area,severity,collateral?circulation?and?hemodynamic. ????Key?Words:BuddChiari?syndrome;Color?Doppler?ultrasonography;Hemodynamic ????BuddChiari综合征（B－CS）是由于肝静脉和(或)肝段下腔静脉完全或部分性阻塞而引起的症状群。本文应用彩色多普勒超声检测，以探讨B－CS特征性异常血管形态及其血流动力学变化。 　　1??资料与方法 ????本组85例患者，男62例，女23例，年龄22岁～58岁，平均36岁。临床表现有腹胀、乏力、肝大、脾大、腹水、胸腹壁静脉曲张、浮肿、黄疸等症状。全部病例由临床初诊，均行彩色多普勒超声及X线血管造影检查证实。手术治疗55例，行下腔静脉破膜术，下腔静脉、肝静脉隔膜切除术，下腔静脉球囊扩张术等。 ????仪器采用LOGIQ?7型彩色多普勒超声诊断仪，探头频率3.5?MHz凸阵探头