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目的评价内镜下预防食管胃静脉曲张患者再出血(二级预防)对门静脉系统血流动力学的影响,以指导临床治疗方案的确定。方法运用超声检查对有出血史的食管胃静脉曲张患者的门静脉系统压力和血流压力包括血管内径、横截面积和平均血流速度进行评价,在二级预防静脉曲张根除后,再次用超声检查评价门静脉系统血流动力学。结果 42例患者在二级预防治疗后1~27个月的随访时间内,达到静脉曲张完全根除,治疗前后超声检查对门静脉系统血流动力学的评估显示,肝动脉内径和肝动脉横截面积显著增宽,其他评估指标治疗前后差异均无统计学意义。结论二级预防治疗静脉曲张再出血,可能使门脉压力有所升高,这需要更大的样本量和长期的跟踪随访来进一步证实。
Objective To evaluate the effect of endoscopic treatment on portal hemodynamics in patients with esophagogastric variceal bleeding (secondary prevention) to guide the determination of clinical treatment plan. Methods The echocardiographic examination of portal system pressure and flow pressure, including intravascular diameter, cross-sectional area and mean velocity of blood flow in patients with esophageal varices with a history of bleeding was performed. After secondary prevention of variceal edema, ultrasonography Evaluation of portal vein hemodynamics. Results 42 patients achieved complete eradication of varicose veins within 1 to 27 months after secondary prevention and treatment. The assessment of portal hemodynamics by echocardiography before and after treatment showed that the diameter of hepatic artery and the cross-sectional area of hepatic artery Significantly widened, the other evaluation indicators before and after treatment were no significant difference. Conclusion Secondary prevention of variceal rebleeding may lead to increased portal pressure, which requires further sample size and long-term follow-up to further confirm.