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目的探讨超声检查在慢性乙肝肝硬化患者胆囊改变中的应用效果。方法抽取2014年2月至2016年6月96例乙肝肝硬化患者,依据肝功能Child-Pugh分级分为A级组(n=33)、B级组(n=31)和C级组(n=32),另选取31例同期体检健康者作对照组,均行超声检查。对比不同时间肝功能分级与胆囊壁厚度、胆囊前后径相关性,分析肝功能分级与凝血酶原时间、肝功能指标、腹水、脾大及门静脉主干内径的相关性。结果空腹胆囊壁厚度及餐后1.0 h和2.0 h胆囊壁厚度增加量与肝功能分级呈正相关(P<0.05);空腹胆囊前后径及餐后1.0 h胆囊前后径缩短量与肝功能分级呈负相关关系(P<0.05),餐后2.0 h胆囊前后径缩短量与肝功能分级无明显相关性(P>0.05);胆红素、凝血酶原时间、腹水、脾大及门静脉主干内径与肝功能分级呈正相关(P<0.05),白蛋白与肝功能分级呈负相关(P<0.05)。结论超声诊断可有效评估乙肝肝硬化患者肝功能分级与胆囊壁厚度和前后径变化的相关性,具有推广价值。
Objective To investigate the effect of ultrasonography on gallbladder changes in patients with chronic hepatitis B cirrhosis. Methods A total of 96 patients with hepatitis B cirrhosis from February 2014 to June 2016 were selected and divided into A group (n = 33), B group (n = 31) and C group according to Child-Pugh classification = 32), the other 31 cases of the same period were selected as the control group, all underwent ultrasound examination. The correlation between liver function grading and gallbladder wall thickness and gallbladder anteroposterior diameter was compared at different times. The correlation between liver function grading and prothrombin time, liver function, ascites, splenomegaly and portal vein diameter was analyzed. Results The fasting gallbladder wall thickness and the increase of gallbladder wall thickness at postprandial 1.0h and 2.0h were positively correlated with the grading of liver function (P <0.05). The anteroposterior diameter of fasting gallbladder and 1.0h postprandial gallbladder anterior and posterior diameter shortening and liver function grading were negative (P <0.05). There was no significant correlation between the shortening of gallbladder anteroposterior diameter and postoperative 2.0 h of postprandial function (P> 0.05); bilirubin, prothrombin time, ascites, splenomegaly, There was a positive correlation between functional classification (P <0.05), albumin and liver function classification was negatively correlated (P <0.05). Conclusion Ultrasound diagnosis can effectively evaluate the correlation between liver function grading and gallbladder wall thickness and anteroposterior diameter in patients with cirrhosis of hepatitis B, which has the value of popularization.