肝阻抗血流图评价门静脉高压症患者贲门周围血管离断术前后肝血流灌注的改变  

Rheohepatogram in evaluation of liver blood perfusion in portal hypertensive patients undergoing pericardial devascularization

作　　者：陈立波[1] 王国斌[1] 杨镇[2] 

机构地区：[1]华中科技大学协和医院外科,武汉430022 [2]同济医院外科

出　　处：《中华普通外科杂志》2001年第12期732-734,共3页Chinese Journal of General Surgery

摘　　要：目的利用肝阻抗血流图探讨肝硬化门静脉高压症患者的肝脏血流灌注改变和贲门周围血管离断术对肝血流灌注的影响。方法选取 2 2例肝硬化门静脉高压症患者 ,分别在术前 1周、术后 2周检测其肝血流阻抗的改变 ,同时用Doppler彩超检测门静脉血流动力学的变化。结果肝阻抗血流图测定结果表明 ,门静脉高压症患者的肝动脉、门静脉向肝血流灌注明显下降 ,总肝灌注血流降低〔(0 0 5 3± 0 0 11)比 (0 0 31± 0 0 0 9)、(0 0 33± 0 0 11)比 (0 0 18± 0 0 0 8)、(7 7± 3 0 )比 (3 5±1 7) ,P <0 0 5〕 ;断流术后门静脉高压症患者的门静脉向肝灌注增加〔(0 0 18± 0 0 0 8)比 (0 0 2 6±0 0 0 6 ) ,P <0 0 5〕 ,肝动脉向肝灌注无显著改变。结论肝硬化患者肝动脉、门静脉向肝有效血流灌注都降低 ,肝脏总血流量下降 ;贲门周围血管离断术能增加大部分患者的门静脉向肝血流灌注 ,但对肝动脉的向肝灌注无显著影响 ;肝阻抗血流图对于评价肝硬化患者的肝脏血流及手术对肝脏血流动力学的影响有一定的价值。ObjectiveTo evaluate the changes of hepatic blood perfusion in cirrhotic patients undergoing pericardial devascularization (PCDV).MethodsHepatic artery and portal vein perfusion of 22 pre- and post- PCDV cirrhotic patients were evaluated with rheohepatogram(RHG) and ultrasonography (USG).ResultsCompared with normal control, the hepatic artery, portal vein effective perfusion and total hepatic perfusion decreased on RHG 〔(0.053±0.011) vs. (0.031±0.009),(0.033±0.011) vs. (0.018±0.008),〔(7.7±3.0) vs. (3.5±1.7), all P<0.05〕, portal vein perfusion increased after PCDV 〔(0.018±0.008) vs. (0.026±0.006), P<0.05〕. Conclusions In cirrhotic patients portal venous and hepatic arterial perfusion decreased, PCDV increased portal vein and overall liver perfusion in most patients.

关 键 词：血液动力学 门静脉高压症 肝阻抗血流图 贲门周围血管离断术 肝硬化 

分 类 号：R657.3[医药卫生—外科学]