The Role Of Umbilical Vein Recanalization In Progression Of Cirrhosis

Background:Liver cirrhosis is a final stage change of chronic hepatic disease.Portal vein hypertension is the most prominent characteristic of cirrhosis.The one of portal vein hypertension's main feature is Collateral ciculation formation,one more common type of which is umbilical vein recanalization(UVR).But clinical significances of umbilical vein recanalization in patients with cirrhosis are unknown.Objective:To study patients with liver cirrhosis complicated by umbilical vein recanaliza-tion clinical characteristics.To explore its relationship with liver damage,hepatic encephalopathy,ascites,portal vein thrombosis,esophageal varices,and gastroint-estinal bleeding and the clinical significance of umbilical vein recanalization.Materials and Methods:Between Jan 2012 and Oct 2015,inpatients with cirrhosis in the Second Affiliated Hospital of Nanchang University Digestive medical are collected.These patients ware diagnosed by Computed Tomography conjuncting and other clinical indicators.We determines whether there is umbilical vein recanalization by CT,randomly selecteing 50 patients with umbilical vein recanalization as test group(UVR group)and 100 patients with umbilical vein non-recanalization as control group(nonUVR group).These patients general condition,medical history characteri-stics,serum biochemical parameters,electronic endoscopy,abdominal ultrasonogra-phy and abdominal CT and other information are collected.Then applying SPSS17.0software for statistical analysis.Results:A total of 247 cases are diagnosed in patients with cirrhosis,which is 50 cases of umbilical vein recanalization.Umbilical vein recanalization rate is 20.2%.Contrasting UVR Groups and Non-UVR Groups,95% CI of albumin,bilirubin,INR,creatinine are respectively,-2.48~0.54(P1=0.206),-31.6~4.34(P2=0.99),-0.15~0.15(P3=0.457),-22.0~10.0(P4=0.134).There was no significant change in these values.The proportion of Child-Pugh classification for A,B,C class is respectly 8.7%,42%,49.3%(P <0.05).R value of MELD score were respectly 7.94 ± 5.87,6.67 ± 4.69(P>0.05).Hepatic encephalopathy incident rates for UVR group,non-UVR group were respectly 20%,14%(P <0.05).Without ascetic,in UVR group and non-UVR group,was 17(34%),23(23%)(P>0.05).And moderately severe ascetic was 13(26%),26(26%),respectly.Without esophageal varices rates for two groups ware in turn 10%,11%(P>0.05).Severe esophageal varices rates ware 48%,54%(P>0.05).Gastroint-estinal bleeding rates for UVR group was 32%(16/50),non-UVR group was 39%(39/100)(P> 0.05).Portal vein thrombosis rates for UVR group,non-UVR group were respectly 8%,12%(P> 0.05).Cavernous transformation of portal vein in UVR group had none cases,and the other group had 8 patients(P <0.05).Conclusion:Umblical vein recanalizition can't reduce gastrointestinal bleeding and ascetic incidence,and have no effect on portal vein thrombosis.It could decrease ChildPugh classification,while it have no influence on MELD score.Wherever,UVR would increase the incidence of hepatic encephalopathy.Therefore,UVR had no positive effect on cirrhosis,possibly being a sign of disease progression.