Results of instrumental methods of examination in patients with liver cirrhosis with manifestations of hepatic enceph-alopathy

Abstract

The aim of the study. Using instrumental methods to assess the functional status of the liver in patients with cirrhosis. Materials and methods. The study involved 95 patients with CP who were hospitalized from 2018 to 2020 in the De-partment of Anesthesiology and Intensive Care, Surgical and Gastroenterological Departments of the Transcarpathian Re-gional Clinical Hospital. Andriy Novak (Uzhhorod). Group I (Child-Pugh class A - compensation stage) included 18 (18.95%) patients, group II (class B - subcompensation stage) - 25 (26.3%) patients, group III (class C) - stage of decompen-sation) included 52 (54.7%) patients. The shape, size, structure of the liver and spleen, the presence or absence of ascitic fluid in the abdominal cavity were studied by ultrasound. During the visualization of vascular structures, the length, shape, size of the lumen and their anatomi-cal location were evaluated. Endoscopic examination of the upper gastrointestinal tract was performed in all patients accord-ing to conventional methods. Endoscopic examination took into account the severity of esophageal and / or gastric STIs. Results. Among all patients with CP, a decrease in liver size was more common - in 52 patients (54.7%), liver of normal size was found in 26 patients (27.4%), in 22 patients (23.2%) diagnosed with enlarged liver. An increase in the size of the liver was most often observed in patients of group I (55.8%) and diagnosed with almost the same frequency in patients of groups II and III (from 22.0% to 22.8%) - p <0.05. No patient of group I was diagnosed with STIs. In this group, the most common detection of esophageal STDs of II and I degrees (55.6% and 38.9%). In patients of group II most often there was an esophageal SAR of the III century. (40.0%), respectively. No patient of group III was diagnosed with esophageal STI of the first degree, in this group most often found esophageal STD of the third degree and STI of the stomach (51.9% and 34.6%). Conclusions. 1. In patients with group III CP, the maximum decrease in volumetric blood flow in v. lienalis (514.3 ± 22.2 ml / min). 2. The highest blood flow through the splenic artery and vein is observed in patients of group I. 3. According to the indicators of portohepatic hemodynamics in patients of group III there is a pronounced obstruction of hepatic blood flow.