肖绍树[5]认为B超检测门静脉内径≥1.5 cm、脾静脉内径≥1.0 cm、胃左静脉内径>(9.35±1.09)mm、胃短静脉内径>10 mm可作为预测食管静脉曲张出血的参考指标。成建萍等[6]报道,门静脉内径、脾静脉内径与食管静脉曲张有一致性。也有人认为门静脉内径、脾静脉内径、Child分级等能预测食管静脉曲张[7]。本组试验将门静脉内径、脾静脉内径和评价肝功能的ChildPugh值进行比较,各组间差异无显著性,考虑可能与样本数较少有关。
综上所述,笔者认为外周血小板计数、脾长径及二者比值、脾脏指数等指标与有无食管静脉曲张有一定相关性,而血小板计数/脾长径比值可作为预测有无重度食管静脉曲张的指标。由于上述指标的检测具有操作简单、安全无创等优点,可在临床上推广使用。
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