微波消融脾脏的前期研究——肝硬化脾大中脾动脉的血流分布特点  

Study on Characteristics of Arter Blood Flow Distribution in Cirrhotic Splenomegaly Prior to Splenic Microwave Ablation

作　　者：高永艳[1] 李春伶[1] 姚秀萍[1] 梁萍[2] 

机构地区：[1]武警总医院南楼特诊科,北京市100853 [2]解放军总医院超声科

出　　处：《中国超声医学杂志》2008年第7期627-630,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家十五重点攻关项目(2004BA714B10);国家自然科学基金项目(No30371367)

摘　　要：目的探讨肝硬化脾大脾各级动脉的血流分布特点,以保证微波消融脾的安全性及有效性。方法56例肝硬化脾大脾亢患者,根据临床分类标准分为轻、中、重度3组,测量入脾前脾动脉主干及脾门区、中间区、周围区内动脉的峰值流速(PV),并与正常对照组进行比较;20例脾大患者,测量上、中、下入脾的段动脉PV并进行比较。结果脾动脉主干、脾门区动脉、中间区动脉PV均随着脾大程度增高而依次增高,其中脾动脉主干PV重度组与对照组有显著性差异(P<0.05),脾门区动脉、中间区动脉PV轻、中、重3组与对照组比较均有显著性差异(P<0.05),而靠近脾被膜的周围区4组之间均无显著性差异(P>0.05)。肝硬化脾大患者脾脏下部动脉的PV明显低于中、上部(P<0.05)。结论肝硬化脾大中脾动脉流速增高,周围区和下极流速相对较低,是脾脏微波消融可选择的相对安全的进电极入路和消融区。Objective To investigate the characteristics of arterial blood flow distribution in cirrhosis with splenomegaly in order to quarantee the safety and efficacy of splenic microwave ablation. Methods Fifty-six cirrhosis cases with splenomegaly and hypersplenism were divided into 3 groups of slight, moderate and severe splenomegaly on the basis of clinical criterion, Peak velocities （PV） of the main splenic artery, hilum area, middle area and peripheral area arteries were surveyed with pulse wave Doppler ultrasound and compared with the data of the normal control group. Segment arterial PVs in the superior, middle and inferior splenic area in 20 patients with splenomagaly were measured and compared, Results The PVs were increased along with the severity of splenomegaly, There was significant difference of the main splenic artery between the severe group and the control group （P〈O, 05） . The PVs in the hilum area artery and middle area artery were also significantly different in the three splenomegaly groups, compared with the control group （P〈0. 05） , The PVs in peripheral area showed no significant difference in the four groups （P〉0. 05）. The velocity in the inferior splenic area was obviously lower than those in the superior and middle area （P〈0.05） .Conelusions Splenic artery and its branches displayed higher flow velocity in cirrhosis patients splenomegaly, The peripheral and inferior areas with relatively lower velocities are safer to be selected for entrance of electrodes and the approachable ablation area.

关 键 词：肝硬 化脾 动脉 彩色多普勒超声 微波 

分 类 号：R575.2[医药卫生—消化系统]