门静脉血栓的超声动态观察诊断及分析(1)
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[摘要] 目的：探讨有效防止门静脉血栓的漏诊、误诊以致严重并发症发生的方法，并通过各项指标的变化，作为临床用药的指标之一。方法：本院肝硬化合并PVT患者5例。使用PHILIPS HD7超声诊断仪多方位、多切面扫查肝脏，探查门静脉、脾静脉及肠系膜上静脉并详细测量及记录。通过动态观察并比较上述病例通过溶栓治疗后各项指标的变化，作为临床用药指标之一，并观察PVT的转归。结果：病例通过动态观察，血栓均逐渐缩小直至消失，门静脉血流及部分病例增宽的门静脉主干内径亦逐渐恢复正常，有效防止了漏诊、误诊。溶栓治疗后，各项观察指标逐渐恢复正常，患者临床症状减轻。结论：在肝硬化及肝硬化门静脉高压脾切除术后，对出现门静脉血栓的患者进行超声动态观察诊断及临床治疗效果对比分析，简单、无创、效果好，值得应用。
[关键词] 肝硬化；门静脉高压；血栓；多普勒超声
[中图分类号] R445.1 [文献标识码] B [文章编号] 1673-7210(2011)06(c)-108-02
Dynamic observation of ultrasonic diagnosis and analysis of portal vein thrombosis
XIANG Qingyu, CAO Rong, XIANG Qiyun
The Third People's Hospital in Yichang City, Hubei Province, Yichang 443000, China
[Abstract] Objective: To study the missed diagnosis and misdiagnosis of effective prevention of portal vein thrombosis resulting in serious complications, and the indicators of change, as one of the indexes of clinical medication. Methods: This cirrhosis PVT in patients with a total of 5. PHILIPS HD7 ultrasound diagnostic equipment multi-directional, multiple slices scanning in liver, probing the portal vein and spleen vein and superior mesenteric vein and detailed measurement and recording. By observation and comparison of the above cases after thrombolytic therapy by indicators of change, as one of the clinical indicators and observe PVT vest. Results: The such cases by dynamic observation, thrombosis is gradually reduced until it disappears, portal vein blood flow and some cases widening the inner diameter of Portal vein also gradually returned to normal, effectively preventing the missed diagnosis and misdiagnosis. After thrombolytic therapy, the outcome measures gradually returned to normal, reduce clinical symptoms. Conclusion: In patients with liver cirrhosis and liver cirrhosis with portal hypertension after splenectomy, appear for dynamic observation of ultrasonic diagnosis of Portal vein thrombosis patients and comparative analysis of clinical treatment effect, simple, non-invasive, effective, and applications.
[Key words] Liver cirrhosis; Portal hypertension; Thrombosis; Doppler ultrasound
门静脉血栓形成(portal vein thrombosis，PVT)是一种深部血管阻塞性疾病，是肝硬化(LC)失代偿期门静脉高压及门静脉高压断流术后的并发症之一。Webster等将门静脉血栓分为4种类型：I型是指PVT局限于门静脉主干，而未达脾静脉或肠系膜上静脉；Ⅱ型为PVT扩展入肠系膜上静脉，但血流通畅；Ⅲ型为脾静脉PVT形成，但有大侧支循环形成；Ⅳ型是脾静脉PVT形成而无大侧支循环形成[1]。无论哪种类型的PVT ......
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