| 摘要: |
| 目的 探讨常规超声及超声造影(CEUS)定量参数评估肝硬化门脉高压(PHT)患者经静脉肝内门体静脉支架分流术(TIPS)后短期疗效的应用价值。方法 选取2019年1月~2023年1月山西省运城市中心医院接受TIPS治疗的85例PHT患者,均于术前1d及术后1个月行常规超声检查和CEUS检查。比较支架植入前后门静脉压力梯度(PPG)；比较手术前后门静脉内径(PVD)、脾静脉内径(SVD)、肠系膜上静脉内经(SMVD)、门静脉血流速度(PVV),脾静脉血流速度(SVV)、肠系膜上静脉血流速度(SMVV)和到达时间(AT)、达峰时间(TTP)、上升时间(RT)、峰值强度(PI)、上升支斜率(AS)；Pearson相关性分析PHT患者TIPS术后常规超声指标、CEUS定量参数水平与术后PPG的关系。结果 PHT患者TIPS支架植入后PPG为(13.42±2.03)mmHg,显著低于支架植入前的(31.76±6.28)mmHg(P＜0.05)；PHT患者TIPS术后PVD、SVD、SMVD较术前明显降低,PVV、SVV、SMVV较术前明显增加(P＜0.05)；Pearson分析,术后常规超声指标中PVV、SVV、SMVV与PPG呈显著负相关(P＜0.05)；PVD、SVD、SMVD与PPG无相关性(P＞0.05)；PHT患者TIPS术后AT、TTP较术前明缩短,PI、AS较术前明显升高(P＜0.05)；Pearson相关性,PHT患者TIPS术后AT、TTP与术后PPG呈显著正相关,术后PI、AS与术后PPG呈显著负相关(P＜0.05)。结论 常规超声和CEUS定量参数均可无创监测PHT患者TIPS手术前后门静脉压力变化情况,其中CEUS定量参数可更好的应用于TIPS术后短期疗效的监测评估。 |
| 关键词: 常规超声 超声造影 肝硬化门脉高压 经静脉肝内门体静脉支架分流术 短期疗效 |
| DOI： |
| 投稿时间：2023-12-21修订日期：2024-01-08 |
| 基金项目: |
|
| Application value of routine ultrasound and contrast-enhanced ultrasound quantitative parameters in evaluating short-term curative effect in patients with cirrhotic portal hypertension after TIPS |
| liyingqi,dinglinru |
| () |
| Abstract: |
| Objective To explore the application value of quantitative parameters of routine ultrasound and contrast-enhanced ultrasound (CEUS) in evaluating the short-term curative effect in patients with cirrhotic portal hypertension (PHT) after transjugular intrahepatic portosystemic shunt (TIPS). Methods A total of 85 patients with PHT undergoing TIPS in Yuncheng Central Hospital were enrolled between January 2019 and January 2023. All underwent routine ultrasound and CEUS examinations at 1d before surgery and 1 month after surgery. The portosystemic pressure gradient (PPG) before and after stent implantation, portal vein diameter (PVD), splenic vein diameter (SVD), superior mesenteric vein diameter (SMVD), portal vein flow velocity (PVV), splenic vein flow velocity (SVV) and superior mesenteric vein velocity (SMVV) before and after surgery, arrival time (AT), time to peak (TTP), rise time (RT), peak intensity (PI) and ascending branch slope (AS) were compared. The relationship between routine ultrasound indexes, CEUS quantitative parameters and PPG in PHT patients after TIPS was analyzed by Pearson correlation analysis. Results PPG after TIPS stent implantation was significantly lower than that before stent implantation [(13.42±2.03) mmHg vs (31.76±6.28) mmHg, P<0.05]. After TIPS, PVD, SVD and SMVD were significantly decreased, while PVV, SVV and SMVV were significantly increased (P<0.05). Pearson correlation analysis showed that PVV, SVV and SMVV were significantly negatively correlated with PPG (P<0.05), while PVD, SVD and SMVD was not correlated with PPG (P>0.05). After TIPS, AT and TTP were significantly shortened, PI and AS were significantly increased (P<0.05). Pearson correlation analysis showed that AT and TTP were significantly positively correlated with PPG, while PI and AS were significantly negatively correlated with it (P<0.05). Conclusion Both routine ultrasound and CEUS quantitative parameters can noninvasively monitor the changes of portal vein pressure in PHT patients before and after TIPS. CEUS quantitative parameters are more effective to monitor and evaluate the short-term curative effect after TIPS. |
| Key words: Routine ultrasound Contrast-enhanced ultrasound Cirrhotic portal hypertension Transjugular intrahepatic portosystemic shunt Short-term curative effect |
