彩色多普勒超聲診斷腹腔干動脈狹窄的臨床價值

饒偵宏，華先平，王賢明，袁雪芬，梅　麗，涂朝霞

（1.湖北省丹江口市三官殿辦事處衛生院　醫技科，湖北　丹江口　442000；2.湖北醫藥學院　附屬隨州醫院，湖北　隨州　441300）

彩色多普勒超聲診斷腹腔干動脈狹窄的臨床價值

饒偵宏1，華先平*2，王賢明2，袁雪芬2，梅麗2，涂朝霞2

（1.湖北省丹江口市三官殿辦事處衛生院醫技科，湖北丹江口442000；2.湖北醫藥學院附屬隨州醫院，湖北隨州441300）

摘要：目的探討彩色多普勒超聲檢查在評估腹腔干動脈狹窄中的價值。方法應用彩色多普勒超聲診斷儀對腹痛患者的腹腔干動脈進行檢查，觀察的內容包括腹腔干起始段管腔有無斑塊、血栓等引起的狹窄，測量腹腔干狹窄處收縮期峰值速度（peak systolic velocity，PSV）。以30例門診常規體檢患者為對照組，彩色多普勒檢查對照組腹腔干二維聲像改變，并測量起始段血流PSV。結果彩色多普勒超聲共檢出24例腹腔干動脈狹窄，其中起始段粥樣硬化斑塊16例，血栓栓塞7例，孤立性夾層動脈瘤并血栓形成1例。狹窄處血流PSV最高為420 cm/s，最低為228 cm/s，平均為（304.52±53.75）cm/s。對照組腹腔干起始段血流PSV最高為178 cm/s，最低為81 cm/s，平均為（113.33±19.70）cm/s。狹窄組患者腹腔干狹窄處血流速度明顯高于對照組起始段血流速度，差異有統計學意義（t =16.242，P＜0.000 1）。結論彩色多普勒超聲檢查對腹腔干狹窄診斷價值較高，能夠準確顯示腹腔干狹窄的部位、狹窄程度和血流動力學的改變，對腹痛患者的病因篩選有重要的臨床意義。

關鍵詞：彩色多普勒超聲；腹腔干動脈狹窄；血栓；孤立性夾層

Value of CDFI in Diagnosis of Celiac Artery Stenosis

RAO Zhenhong1，HUA Xianping*2，WANG Xianming2，YUAN Xuefen2，MEI Li2，TU Zhaoxia2
（1.Health Center of Sanguandian Office of Danjiangkou City of Hubei Province，Danjiangkou 442000，Hubei，China；2.Affiliated Suizhou Hospital，Hubei University of Medicine，Suizhou 441300，Hubei，China）

Abstract：Objective To explore the value of color doppler flow imaging（CDFI）in diagnosis of celiac artery（CA）stenosis.Methods The patients with abdominal pain were examined by CDFI to evalutate the initial segment of CA on observations of plaques，thrombus etc.And the peak systolic velocity（PSV）of stenotic location was measured.30 out- patients for healthcare were the control group，the twodementional sonograms were revealed and the PSV of CA initial segment were measured.Results 24 cases with CA stenosis were detected by sonography，including atherosclerotic plaque in 16，embolism by thrombus from rheumatic heart disease or acute myocardium infarction in 7，isolated dissection complicated with thrombus in 1.The maximum and minimum PSV at stenosis location was 420 cm/s and 228 cm/s respectively with an average of（304.52±53.75）cm/s.In patients without CA stenosis，the maximum and minimum PSV at initial segment was 178 cm/s and 81 cm/s with an average of（113.33± 19.70）cm/s，which were lower than those in stenotic group with statistical significance( t =16.242，P＜0.000 1).Conclusion CDFI is of great value in diagnosis of CA stenosis，which can accurately display the location and degree of stenosis and the hemodynamic changes，which plays an important role in etiological screening for patients with abdominal pain.

Keywords：color Doppler flow imaging（DFI）；celiac artery stenosis；thrombus；isolated dissection

腹腔干動脈狹窄（celiac artery stenosis，CAS）患者臨床并不少見，但多數患者無明顯癥狀，少數可出現腹痛、腹脹、體重減輕等癥狀，其臨床表現無特異性，體格檢查多無明顯異常，與源于消化道疾病的癥狀不易鑒別，從而造成漏診或誤診?！?br>