进餐对肝硬化患者门静脉血流动力学影响的超声研究  

Ultrasonic research on impact of dining on portal venous hemodynamics of patients with hepatocirrhosis

作　　者：刘会敏[1] 曹晖[2] 

机构地区：[1]新疆维吾尔自治区人民医院急诊科,新疆乌鲁木齐830001 [2]新疆维吾尔自治区人民医院功能科,新疆乌鲁木齐830001

出　　处：《临床和实验医学杂志》2007年第11期22-23,共2页Journal of Clinical and Experimental Medicine

摘　　要：目的通过超声检查了解进餐对肝硬化患者门静脉主干血流(PVF),肠系膜上静脉血流(SMVF)和脾静脉血流(SVF)血流动力学的影响。方法分别在空腹,餐后30、60、90、120min,测定门静脉主干,肠系膜上静脉和脾静脉的血流速度和血管内经,并计算每公斤体质量血流量。结果空腹状态下,肝硬化组SVF与对照组相比显著增大(P<0.05)。对照组SMVF+SVF要低于PVF,而肝硬化组SMVF+SVF要大于PVF,并且大于对照组SMVF+SVF(P<0.05)。餐后,无论肝硬化组还是对照组餐后90min内各个时间的PVF和SMVF均较空腹时明显增加(P<0.05)。餐后对照组SMVF+SVF仍低于PVF,肝硬化组餐后SMVF+SVF增大更明显(P<0.05)。结论肝硬化患者,餐前肝外门脉系统已存在门体分流。餐后SMVF增加使更多的门脉血通过侧支循环直接进入体循环,造成侧支循环血量增加,故认为肝硬化患者进餐所造成的肝外侧支循环血流增加,对食管胃底静脉曲张出血的防治有重要意义。Objective To understand impacts of dining of patients with hepatocirrhosis on their portal venous flow （ PVF）, superior mesenteric venous flow （SMVF） and splenic venous flow （SVF） through ultrasonic examination. Methods Blood flow rate and intravascular diameter of patients＇PV, SMV and SV before meals, 30,60,90 and 120 minutes after meals were measured and volume of blood flow/kilogram （ body weight） was calculated. Results Before meals： SVF of people with hepatocirrhosis increased obviously compared with control group （ P 〈 0. 05 ）. SMVF ＋ SVF of control group were lower than PVF and higher for people with hepatocirrhosis. Also SMVF ＋ SVF for people with hepatocirrhosis were higher than those of control group. After meals： PVF and SMVF measured within 90 minutes after meals for both hepatocirrhosis group and control group increased evidently （ P 〈 0. 05 ）. SMVF ＋ SVF of control group was lower than PVF while much higher than SVF for patients with hepatocirrhosis after meals （ P 〈 0. 05 ）. Conclusion There is portal systemic shunt in extrahepatic portal system before meals for patients with hepatocirrhosis. Due to increase of SMVF after meals, more portal blood enters systemic circulation through collateral circulation which leads to increase of blood in collateral circulation. So we think increase of blood in collateral circulation caused by dining of patients with hepatocirrhosis is very important for prevention and treatment of variceal haemorrahage in cirrhosis.

关 键 词：肝硬化 多普勒超声 门脉高压 血流动力学 

分 类 号：R575.2[医药卫生—消化系统]