原发性肝癌介入治疗前后肝脏血流动力学研究  

Study of Hepatic Hemodynamics Before and After Interventional Therapy for PHCC

作　　者：胡舜华[1] 杨绍珑[1] 章蓉[1] 王占春[1] 葛忠[1] 

机构地区：[1]青岛市立医院,266011

出　　处：《医学影像学杂志》1997年第3期156-159,共4页Journal of Medical Imaging

摘　　要：目的：应用彩色多普勒超声研究原发性肝癌（PHCC）病人介入治疗前后的血流动力学变化规律。材料和方法：选择20例PHCC病人，与20位正常人的血流动力学进行比较，20例肝癌病人介入治疗前后和介入治疗后近期和后期的血流动力学变化进行动态测定观察。测定内容包括肝固有动脉和门静脉的直径、血流速度和血流量，全肝血流量和肿瘤血流特点。结果：PHCC病人肝固有动脉内径增大、血流速度增快、血流量增多（P＜0.05）；虽然门静脉的血流速度减慢、门脉内径增宽、血流量也增加，但PHCC病人是以肝固有动脉血流量的骤增为特点。介入治疗后现一周内，肝固有动脉内径、血流速度和血流量均下降（P＜0．05）；门脉内径虽无明显变化，但血流速度和血流量均明显代偿性增加（P＜0．01），致使肝脏的总血流量增加（P＜0．05）。介入治疗后一个月，肝固有动脉及门静脉内径与介入治疗后一周内虽无明显变化，但两者的血流速度和血流量、以及总肝血流量均明显下降（P＜0.05）。与介入治疗后近期所不同的是以肝固有动脉和门脉血流量的进一步降低、并渐恢复或接近治疗前的水平为其特点。结论：①大多数原发性肝癌病人的肝脏肿瘤是以动脉供血为主，超声测得的肝动脉血流量超过500ml／分时，对诊断PHCC有助。Purpose:To find the regularity of the hemodynamic change before and after tran shepatic artery embolization(TAE)for the patients with primary hepatocellular carcinoma (PHCC).Materials and methods:Twenty patients with PHCC were chosen for this study.and the contrasting study was also donc with twenty normai persons by use of colour Doppler.The hemo dynamic measurement included hepatic artery(HA),portal vein(PV).total hepatic and tumour blood flow before TAE and early and late stage after TAE.Results;The hemodynamic change of PHCC was mainly characterize by remarkable increasing of BF of HA.There were a remarkable hemodynamic change in both liver and tumour before and after TAE.In early stage(within on week)after TAE＜the velocity and the amount of BF of HA were remarkable increaseing(P＜0.05).The velocity of PV was decreasing,but the amount of BF of PV were increasing(P＜0.05)Therefore the total amount of hepatic BF was remarkable increasing(P＜0.05).In later stage (one month)after TAE＜the diameter of both HA and PV had no rernarkable change.both the ve locity and amount of blood flow of HA and PV,the total blood flow of th liver was remarkable de creasing comparing with the early stage(P＜0.05).Conclussion:①The tumour blood supply of PHCC are mainly coming from artery,and it is very helpful for the diagnosis of PHCC if the BF of HA is more than 500 ml/m.②The total hepatic blood flow and the turnour blood supply may be remarkably changed by TAE.③Both the total hepatic blood flow and tumour blood supply were quite different between early and later stage after TAE.

关 键 词：原发性肝癌 介入疗法 肝脏 血流动力学 PHCC 肝血流量 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学]