Assessment of splenic blood flow in patients with the compensated and decompensated course of cirrhosis
Keywords:cirrhosis, splenomegaly, splenic blood flow, ultrasound scanning, dopplerography
Splenomegaly, increased splenic blood flow are the specific characteristics of the natural course of cirrhosis. But an importance of these alienations is inadequately appreciated when choosing methods of correction the portal hypertensia syndrome.
Aim of the study. To assess the splenic blood flow in patients with compensated and decompensated course of cirrhosis.
Materials and methods.190 patients with cirrhosis were under surveillance: 123 had the gastrointestinal bleeding, 67 – the refractory ascites. 84 patients died during surveillance. The surveillance lasted from 2-3 weeks to 2,5 -3 years.
All patients underwent reiterated ultrasound study of an abdominal cavity. The dimensions of spleen, diameter of hepatic and splenic vessels were assessed; the qualitative and quantitative characteristics of blood flow in hepatic and splenic arteries, portal and splenic veins were defined.
Result of the study. All cirrhosis patients have the different degree of splenomegaly with increase of volumetric blood flow in splenic artery and vein in 1,3 and 3,2 times respectively. At the decompensation of disease on the background of decrease of the blood flow in portal vein, hepatic and splenic arteries, the blood flow in splenic vein practically didn’t change. The ratio between the volumetric blood flow in splenic vein and the portal one at decompensation of disease increased from 65,5±18,0 % to 99,1±27,0 %, while the norm is 43,2±15,0 % (р < 0,01), that can be the one of prognostic indications of the complications development.
Conclusions. The natural course of cirrhosis characterizes by increase of the splenic blood flow relative to the portal one when transition from the compensated state to the decompensated one, that can be one of the factors of increase of the portal pressure and hemodynamic causes of the complications development that must be taken into account choosing method of correction the syndrome of portal hypertensia
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Copyright (c) 2015 Алий Саитович Тугушев, Виталий Викторович Вакуленко, Ольга Степановна Черковская, Дмитрий Иванович Михантьев, Вячеслав Васильевич Нешта, Павел Иванович Потапенко
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