彩色多普勒超声检测门静脉高压症三种手术方法治疗前后门静脉血流动力学对比研究  

THE CONTRAST STUDIES AND CLINICAL MEANING OF VARIOUS SURGICAL PROCEDURES ON PORTAL HEMODYNAMICS IN PATIENTS WITH PORTAL HYPERTENSION BY USING COLOR DOPPLER ULTRASOUND

作　　者：刘爱莲[1] 李荔[1] 阮长乐[2] 张曙光[2] 李光新[2] 

机构地区：[1]山东省千佛山医院超声诊疗中心 [2]山东省千佛山医院普外科

出　　处：《中国煤炭工业医学杂志》2008年第4期468-470,共3页Chinese Journal of Coal Industry Medicine

摘　　要：目的采用CDFI(彩色血流显像)和彩色多普勒技术测定脾肾分流术(SRS)、贲门周围血管离断术(PCDV)及联合手术(SRS+PCDV)治疗门静脉高压症三种手术方法治疗前后门静脉系统血流动力学参数,以评价不同术式对门静脉高压症的治疗意义及临床价值。方法将80例门静脉高压症患者分为三组:1组:脾肾分流术(SRS)24例;2组:脾切除加PCDV(断流组)26例;3组:联合手术组行脾切除加近端脾肾分流术(SRS+PCDV)30例,应用CDFI和彩色多普勒检测技术分别检测手术前后门静脉的血流动力学指标,并进行比较研究。结果①SRS组术后较术前门静脉血流量(PVF)减少(52±8)%,差异有统计学意义(P<0.01)。②断流组术后较术前PVF减少(9±6)%,与术前比较差异无统计学意义(P>0.05)。③SRS+PCDV组术后PVF减少(35±6)%,与术前比较差异有统计学意义(P<0.05)。④SRS+PCDV组术后的PVF介于断流组与SRS组之间,且各组之间差异有统计学意义(P<0.05)。结论多普勒超声检测门静脉血流动力学指标有助于评价门静脉高压症的三种术式血流动力学变化、手术效果及预后情况。Objective To study the effects on hemodynamic parameters of portal venous system of splenorenal shunt （SRS） , pericardiac devascularization（PCDV）, and splenorenal shunt Plus pericardia devascularization （SRS ＋ PCDV） by using the color doppler flow imaging（CDFI） and color Doppler ultrasound, and evaluate the treatment meaning and clinical value of this three operative procedure. Methods The 80 patients with portal hypertension were divided into 3 groups randomly, group 1： group 24 patients with splenorenal shunt（SRS）,2.. 26 patients with pericardiac devascularization（PCDV）, and group 3： 30 patients with splenorenal shunt Plus pericardia devascularization （SRS＋ PCDV）. The hemodynamic parameters of three groups with portal hypertension were detected by Doppler color flow imaging（DCFI） and color Doppler ultrasound of before and after operation. Results （1）In groupl（SRS） the postoperative portal venous flow（PVF）decreased by（52 ± 8）% respectively（P〈0.01）. （2）In group 2 （PCDV） PVF decreased by（9±6）% （P〉0.05） , No significant difference was found before and after operation., （3）In group 3 （SRS＋ PCDV） PVF decreased by（35 ± 6）% respectively（P〈0.05）. （4） In group 3 The postoperative decrease of PVF in （SRS＋ PCDV）group were between that of （SRS） and （PCDV） Groups and the difference among the groups was statistically significant（P〈0.05）. Conclusion Hemodynamics By Color Doppler flow Imaging （CDFI） and color Doppler ultrasound the portal hemodynamic changes of patients with portal hypertension（PH） were evaluated before and after splenorenal shunt （SRS） and pericardiac devascularization （PCDV）, and compared with those of 26 patients with pH subjected to PCDV only and 24 patients with pH subjected to SRS only. Results showed that the postoperative PVF of SRS ＋ PCDV group was between that of PCDV and SRS group, there was apositiv ecorrelation the decreasing rate of PVF in the SRS＋ PCDV

关 键 词：彩色多普勒超声检查 血流动力学 门静脉高压症 脾肾分流术 断流术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.2[医药卫生—诊断学]