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目的应用超声测量肝硬化患者颈段胸导管内径,评估不同类型肝硬化患者胸导管内径的差异及意义。方法选取我院临床确诊为慢性肝病肝硬化患者163例,其中慢性乙型肝炎肝硬化(CHB)患者61例,慢性丙型肝炎肝硬化(CHC)患者32例,酒精性肝硬化(AC)患者42例,自身免疫性肝炎肝硬化(AHC)患者28例。同期选取65例健康志愿者作为对照组。应用高频超声测量颈段胸导管内径(CTDd),比较各组CTDd的差异。结果 CHB、CHC、AC、AHC组颈段胸导管超声显示率分别为97%、100%、100%、89%,健康对照组显示率为89%,显示率差异无统计学意义(P>0.05)。健康对照组的CTDd测值最小,为(2.11±0.58)mm;AHC组、CHB组、CHC组AC组CTDd测值分别为(3.96±1.31)mm、(4.49±1.31)mm、(4.62±1.56)mm、(6.07±2.60)mm,较对照组均明显增宽,差异有统计学意义(P<0.000);AHC组、CHB组、CHC组各组间差异无统计学意义(P>0.05);AC组CTDd测值较AHC组、CHB组、CHC组增宽,差异有统计学意义(P<0.01)。结论肝硬化患者胸导管内径较正常人明显增宽,不同病因导致增宽程度有所差别。
Objective To measure the diameter of thoracic duct in patients with cirrhosis by ultrasound and evaluate the difference of thoracic duct diameter in patients with different types of liver cirrhosis. Methods A total of 163 patients with chronic liver disease were enrolled in this study. Among them, 61 patients with chronic hepatitis B cirrhosis (CHB), 32 patients with chronic hepatitis C cirrhosis (CHC), 32 patients with alcoholic liver cirrhosis (AC) 42 cases, autoimmune hepatitis cirrhosis (AHC) in 28 patients. In the same period, 65 healthy volunteers were selected as the control group. Cervical thoracic duct diameter (CTDd) was measured by high-frequency ultrasound and CTDd was compared between groups. Results The diagnostic rates of thoracic duct were 97%, 100%, 100% and 89% respectively in CHB, CHC, AC and AHC groups, and 89% in healthy controls. There was no significant difference between the two groups ). (2.11 ± 0.58) mm in the healthy control group, and (3.96 ± 1.31) mm, (4.49 ± 1.31) mm and (4.62 ± 1.56) mm in AHC group, CHB group and CHC group respectively ), (6.07 ± 2.60) mm respectively, which were significantly higher than those in the control group (P <0.000). There were no significant differences among the groups of AHC, CHB and CHC (P> 0.05) ; CTDd measured AC group than AHC group, CHB group, CHC group widened, the difference was statistically significant (P <0.01). Conclusions The diameter of thoracic duct in patients with cirrhosis is obviously wider than that in normal people, and the widening degree is different due to different causes.