肝门静脉系统栓塞的机制探讨  

Pathogenesis probe of embolism in the portal vein system

作　　者：丁霞[1,2] 赵斌[2] 马子堂[3] 贾守勤[1] 

机构地区：[1]山东大学医学院,济南250012 [2]山东省医学影像学研究所,济南250021 [3]济宁市妇女儿童医院放射科,山东济宁272000

出　　处：《山东大学学报（医学版）》2009年第5期106-108,共3页Journal of Shandong University:Health Sciences

摘　　要：目的分析门静脉系统栓塞的部位分布特点,探讨其发病机制。方法收集经超声、磁共振(MRI)和数字减影血管成像(DSA)检查中至少一项诊断为门静脉系统栓塞的患者267例,所有病例均经CT平扫及增强扫描并与原诊断相符。其中恶性肿瘤组242例均经手术病理或活检证实,其余25例为非肿瘤组。比较所有病例肠系膜上静脉及脾静脉的受累情况,并比较恶性肿瘤组及非肿瘤组门静脉系统栓塞的累及范围。结果①与脾静脉受累程度(17/267,6.4%)相比,门静脉系统栓塞更易累及肠系膜上静脉(145/267,79.2%,P<0.05);分别将恶性肿瘤组及非肿瘤组中肠系膜上静脉及脾静脉受累的情况作比较,结果与前相同(P<0.05);②非肿瘤组中门静脉系统受累程度积分明显高于恶性肿瘤组(P<0.05)。结论门静脉系统栓塞与肠系膜静脉的功能、解剖及血流动力学特点密切相关;非肿瘤性门静脉系统栓塞较恶性肿瘤所致门静脉系统栓塞范围广泛。Objective To analyze the location characteristics of embolism in the portal vein system and to probe the pathogenesis of this disease. Methods 267 cases of embolism in the portal vein system were collected and were given at least one of the following examinations： ultrasound, MRI, or DSA, and all were given plain and enhanced scanning of multi-spiral CT. 242 of them had malignant tumors proved by operation or biopsy. Involved condition of both the upper mesenteric veins and splenic veins were compared, and involved scale of embolism in the portal vein system was detected. Results ① Upper mesenteric veins （145/267,79.2%）were more likely to be involved than splenic veins （17/267,6.4%）in embolism of the portal vein system （ P 〈 0.05）. ② The total number of involved vein sections in the portal vein system of this disease was obviously higher in the non-cancerons group than in the malignant tumor group（ P 〈 0.05）. Conclusion Functional, anatomical and blood dynamic characteristics of the mesenteric vein are greatly related to embolism of the portal vein system. Embolism scale caused by non- cancerous diseases is wider than that caused by malignant tumors.

关 键 词：门静脉 栓塞 发病机制 体层摄影术 X线计算机 

分 类 号：R445[医药卫生—影像医学与核医学]