METHOD FOR DETERMINING DEGREE OF STRUCTURAL LIVER DAMAGE AND INTENSITY OF PORTAL HYPERTENSION IN CHILDREN

FIELD: medicine.SUBSTANCE: intensity of fibrosis and presence of hepatic cirrhosis are appraised by points according to Metavir scale in fibroelastometry and according to Desmet scale in morphological liver examination. A portal hypertension indices are assessed: ultrasonic measurement involves an increase of a portal vein diameter, a splenic vein diameter, a spleen length as a percentage of maximum allowed norm, which is determined by a child's height. The increase of the above indices by 0-4% is appraised as 4 points, by 5-24% - as 3 points, by 25-49% - as 2 points, by 50-95% - as 1 point, by 96-100% - as 0 points each. The presence of umbilical vein recanalisation, abdominal dropsy, cardiac dropsy requires 0 points to be added, and the absence of the above - 4 points each. A fibreoptic esophagogastroduodenoscopy aims at stating oesophageal varicose veins dilatation, and its intensity in points is assessed: the absence of disorders is assessed as 4 points; 1 degree is stated as 3 points, 2 degree - as 2 points, 3 degree - as 1 point, and 4 degree - as 0 points. The total score is derived. If the total score is 38-40, the absence of structural liver damages and portal hypertension is stated. If total score is 30-37 points, a minor liver structure disturbance and slight portal hypertension is diagnosed. Total score of 20-29 points shows a moderate liver structure disturbance and moderate portal hypertension. If total score is 3-19 points, a severe liver structure disturbance and severe portal hypertension is detected.EFFECT: method enables increasing the diagnostic effectiveness for liver disease by identifying objective criteria of the degree of structural liver damage and the intensity of portal hypertension.7 tbl, 3 ex Изобретение относится к медицине, а именно к детской гастроэнтерологии и гепатологии, и может быть использовано для диагностики степени поражения структуры печени и выраженности портальной гипертензии. Оценивают в баллах выраженность фиброза и наличие цирроза печени по шкале Metavir при фиброэластометрии и по шкале Desmet при морфологическом исследовании печени. Оценивают показатели выраженности портальной гипертензии: с помощью УЗИ оценивают увеличение диаметра воротной вены, диаметра селезеночной вены, длину селезенки в процентах от максимально допустимой нормы, которую определяют по росту ребенка. Увеличение указанных показателей на 0-4% оценивают в 4 балла, на 5-24% - в 3 балла, на 25-49% - в 2 балла, на 50-95% - в 1 балл, на 96-100%