部分脾动脉栓塞联合胃冠状静脉栓塞术对门静脉血流动力学的影响  

Influence of percutaneous transhepatic gastric variceal embolization joint partial splenic embolization on he modynamic of portal vein

作　　者：郭建雄[1] 朱军[2] 温晓琴[1] 

机构地区：[1]宜宾市第三人民医院影像科,四川省宜宾644000 [2]宜宾市第二人民医院影像科

出　　处：《中国基层医药》2013年第2期235-237,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨部分脾动脉栓塞联合胃冠状静脉栓塞术对门静脉血流动力学的影响。方法对54例临床明确诊断的肝硬化门脉高压患者行胃冠状静脉栓塞联合脾部分栓塞术治疗，门静脉插管直接测量介入术前、后自由门静脉压（FPP），通过彩超、增强CT扫描比较介入术前、后门静脉（PV）、脾静脉（SV）的血流动力学指标变化。结果胃冠状静脉栓塞术后FPP较术前明显升高[（37．05±4．27）cmH：0与（42．60±5．04）cmH：0，P〈0．01]，联合部分脾栓塞术后复测门静脉压有所降低，但介入术前、后差异无统计学意义（P〉0．05）；介入术后3个月门静脉内径、血流量及血流速度与术前变化不大，而脾静脉内径缩小较明显（P〈0．05），血流速度及血流量显著降低（P〈0．01）。结论单独行胃冠状静脉栓塞会引起门静脉压力升高，联合进行脾部分栓塞术对门静脉血流动力学无明显影响。Objective To explore the effect of percutaneous transhepatic gastric varieeal embolization joint partial splenic embolization on hemodynamie of portal vein. Methods 54 cases who were clinically diagnosed as cir- rhosis with portal hypertension, do the treatment percutaneous transhepatie gastric varieeal embolization combined with partial splenic embolization. The preoperative and postoperative free portal vein pressure（FPP） were measured by por- tal vein intubation, and the preoperative and postoperative portal vein（ PV）, spleen vein（SV） in hemodynamie chan- ges were compared between color dopplar ultrasound and CT scan scanning. Results Free portal vein pressure were significantly increased after percutaneous transhepatic gastric varieeal embolization [ （ 37.05 ± 4.27 ） cm H20 vs （42. 60 ± 5.04 ）em H2O, P 〈 0.01 ], and reduced through continuing to partial splenic embolization. In the end there were no statistically significant differences （ P 〉 0.05 ）. After 3 months portal venous blood flow and inner diameter and blood flow velocity only is a little change,but spleen vein inner diameter,blood flow velocity and blood flow were decreased significantly（P 〈 0.01 ）. Conclusion Only percutaneous coronary arteriovenous embolization can increase portal vein pressure, but which joint partial splenic embolization does not affect the thange of portal venous blood flow dynamics.

关 键 词：脾动脉 门静脉 栓塞 治疗性 血流动力学 

分 类 号：R575[医药卫生—消化系统]