Liver cirrhosis breaks bleeds dangerously to predict _'s symptom

Liver cirrhosis breaks, bleeds dangerously to predict _'s symptom
The liver cirrhosis esophagus is variceal to break, bleed dangerous prediction
Patient nearly has liver cirrhosis every year the esophagus happen variceally in 5%, have after l is annual 10% - 20% While as a child variceal to develop into a great one to be variceal, danger that bleed in the 2 year 20% - 30% , The first bleeding l case fatality rate in week is 25% - 50% . So, prevent from bleeding accurately and choose operation way to prevent and cure and bleed rationally, improve curative effect and judge the prognosis is extremely important. It is sensitive, peculiar not to but does not have yet at present, also there are not the prediction means of wound, agony. Assign to and state commonly used prediction method and pros and cons as follows now.
1. The mirror checks an intravenous nodular expansion of oesophageal song under gastroscope in the upper digestive tract, red earthworm soliciting and bright cherry-red kind of intensity changed while soliciting, predict the important index bleeding.
2. Intravenous pressure gradient (HVPG) of liver Door pulse and high pressure are variceal foundation that is formed of the esophagus, HVPG 2.0Kpa(15mmHg) Can cause the esophagus to be variceal hour. >3. IkPa( 23. 25mmHg) Have danger of esophaguses happen variceally and breaking to bleed promptly hour. But HVPG determines that has wound nature, fails to be regarded as routine inspection clinically; And even if some patients make a definite diagnosis of it door pulse and high pressure, there might not be variceal esophagus either.
3. Spider's pile spider's pile is positive during age 15 mm) Bleeding probability 80. Do not have statistics report to its specificity and sensitiveness yet.
4 . Check the B -type supersound and measure the internal diameter of portal vein and is no more than 1 in supersound. 5 cm, spleen intravenous internal diameter is greater than equalling 1.0cm, short intravenous internal diameter of the stomach is greater than 10mm, can be regarded as the reference index of predicting variceal bleeding of esophagus.
5. The blood vessel of optical fundus can also reflect to detect the change of blood vessel of optical fundus liver cirrhosis whole body blood vessel and blood flow are unusual in dynamics in early days, shown as the optical fundus vein is expanded, the artery is attenuated, even the vein is highly crooked, ooze out things on a small quantity on the retina. Change, aggravate with the blood vessel of optical fundus, the door, spleen vein are increased widely, eating the camp variceally breaks the bleeding rate to obviously increase, it is the positive correlation. Jointly detect value with the B -type supersound relatively tallly.
6. Laboratory check the intersection of blood platelet and 13mm, the esophagus that 56% of the patients exist is variceal, 16% among them are a vein of thick song, can be regarded as and predicted the index. But its specificity or sensitiveness has not been up to 75%.
|