双工多普勒超声对门脉高压症血流动力学的研究  

Study of Portal Venous Hemodynamics in Patiemts with Portal Hypertension by Duplex Doppler US

作　　者：张海[1] 张青萍[1] 

机构地区：[1]同济医科大学附属同济医院

出　　处：《中华超声影像学杂志》1994年第1期14-18,共5页Chinese Journal of Ultrasonography

摘　　要：通过对３１例正常人，４６例门静脉高压症（ｐＨ）患者内脏循环系统的多普勒超声（Ｄ—ＵＳ）血流动力学检测，我们发现：①ｐＨ患者脾静脉与肠系膜上静脉比值（ＱＳＰＶ／ＱＳＭＶ：１．１０６±０．５１）较正常组（ＱＳＰＶ／ＱＳＭＶ；０．７５２±０．２９５）明显增高，ｐＨ组ＱＳＰＶ（６９２．１±３３５．４ｍｌ／ｍｉｎ），ＱＳＭＶ（６４８．８±２８３．４ｍｌ／ｍｉｎ）较正常组明显增加（Ｐ＞０．０１），ｐＨ患者ＱＳＰＶ／ＱＳＭＶ比值平衡破坏及ＴＡＶ·Ａ增多，打破了胃脾区小内脏循环与肠系膜区大内脏循环这两个功能区间屏障，形成食道胃底静脉曲张。②ｐＨ患者肠系膜上动脉（ＳＭＡ），腹腔动脉（ＣＡ）的搏动指数（１．７５±０．８３３，１．２８６±０．７２２）与阻力指数（０．７７２±０．０５５１，０．６９４５±０．０６４９）较正常人ＰＩ，ＲＩ均明显降低，内脏动脉循环呈低阻状态。③门脉血流速度与Ｃｈｉｌｄ—Ｐｕｇｈ计分肝功能分值呈负相关（ｒ＝－０．５２９６，Ｐ均＜０．０１），Ａ级时（１２．８５±１．９２７ｃｍ／ｓ）较Ｂ、Ｃ级时差别明显（１０．４７±２．４２ｃｍ／ｓ，９．５±２．８３ｃｍ／ｓ，Ｐ＜０．０１），可进行肝功能和肝脏病变程度判定。④?The splanchnic venous and arteral systematic hemodynamic of 31 normal controls and 46 patients with pH were detected by Doplex Doppler US. The results shew that (1) The ratio of Pspv/Psmv in Patients with PH (1. 106±0. 51) was higher than the ratio in controls (0. 752±0. 295). The TAV. A of SPV (692. 1±335. 4ml/min) and the TAV. A of SMV (648. 31 283. 4ml/min) in patients with pH were more increased than the controls (P<0. 01). The charge of ratio of Pspv/Psmv and the increase of TAV. A of SPV(Pspv), TAV. A of SMV(Pspv)destory the barriers between lesser(spleen and gastric sepatation) and greater (mesenteric sepatation splanchnic venous system, to formed esophageal varices (EPV). (2)The PI of SMA(1. 75±0. 833), CA(1. 286±0. 722) and the Ri of SMA (0. 722±0. 0511 ), CA(0. 6945±0. 0649) were lower than the contrals (P<0. 01 ). It indicates that circulation of splanchic arteral in pH exist low resistance state. (3)The decrease of the portal venous blood flow velocity (TAV) were closely related to grades of seventy of liver function classfication. (4)Comparision patients with pre and post-operation (splenotomy + devascularigation in cardia), portal blood flow infusion volume were not decreased, We concluded that the patients with pH do exist hyper hemodynamics state which centrel around spleen in spandinic system. Duplex Doppler US is an useful diagnosis tool in the non-invasive detact hemodynamic chang and effect of different treatment, assessment of clinical liver fuction in patients with pH.

关 键 词：血流动力学 门脉高血压 超声波诊断 

分 类 号：R657.340.4[医药卫生—外科学]