部分性脾栓塞联合普萘洛尔对门脉血流动力学的影响  

Clinical study of partial splenic embolization combined with propranolol on portal hemodynamics

作　　者：吴金棉 罗骏阳 梁炎辉 陈大娟 WU Jin-mian;LUO Jun-yang;LIANG Yan-hui;无(Department of medical imaging,The People′s Hospital of Sanshui District,Foshan City,Foshan 528000,China;Interventional Department of the Third Affiliated Hospital of Sun Yat sen University,Guangzhou 510000,China;Department of medical ultrasound,The People′s Hospital of Sanshui District,Foshan City,Foshan 528000,China)

机构地区：[1]佛山市三水区人民医院医学影像科,广东佛山528000 [2]中山大学附属第三医院介入科,广东广州510000 [3]佛山市三水区人民医院医学超声科,广东佛山528000

出　　处：《吉林医学》2022年第5期1198-1202,共5页Jilin Medical Journal

基　　金：佛山市科技创新项目[项目编号:1920001001152]。

摘　　要：目的:探讨部分性脾栓塞(PSE)联合普萘洛尔对门脉血流动力学的影响在肝硬化门脉高压并食管胃底静脉曲张患者中的应用效果。方法:选取确诊的肝硬化门脉高压并食管胃底静脉曲张患者76例为研究对象,随机分为三组,对照A组25例采用PSE治疗,对照B组25例采用普萘洛尔治疗,联合组26例采用PSE加普萘洛尔治疗。比较三组治疗前后门脉血流动力学、脾静脉血流动力学、炎性反应因子水平、食管静脉曲张破裂出血发生率。结果:治疗1周、治疗1个月联合组门静脉流速、门静脉内径、门脉压力、脾静脉流速、脾静脉血流量低于对照A组、对照B组,治疗1周对照A组门静脉流速、门静脉内径、门脉压力、脾静脉流速、脾静脉血流量低于对照B组(P<0.05);治疗1周、治疗1个月联合组白细胞介素-6(IL-6)、C-反应蛋白(CRP)低于对照A组、对照B组,差异有统计学意义(P<0.05);三组食管静脉曲张破裂出血发生率比较差异无统计学意义(P>0.05)。结论:PSE联合普萘洛尔治疗肝硬化门脉高压并食管胃底静脉曲张,可有效改善患者门脉、脾静脉血流动力学,减轻炎性反应。Objective To investigate the effect of partial splenic embolization(PSE) combined with propranolol in patients with portal hypertension and esophageal and gastric fundus varices in cirrhosis.Method 76 patients with liver cirrhosis, portal hypertension and esophagogastric varices were selected as the research objects, they were divided into three groups randomly, 25 cases of control group A treated with PSE, 25 cases of control group B treated with propranolol, A joint group of 26 patients with PSE + propranolol treatment. Hemodynamics of anterior and backdoor veins, splenic venous blood flow dynamics, levels of inflammatory factors and the incidence of esophageal varices rupture and bleeding were compared between the three groups.Results 1 week, 1 month joint treatment group velocity of portal vein and portal vein diameter, velocity of the pressure of portal vein, splenic vein and splenic venous blood flow was lower than the control group A and control group B, 1 week treatment control group A velocity of portal vein and portal vein diameter, velocity of the pressure of portal vein, splenic vein and splenic venous blood flow was lower than the control group B(P<0.05);Interleukin-6(IL-6) and C-reactive protein(CRP) in combined group were lower than those in control group A and control group B after 1 week and 1 month of treatment(P<0.05). There was no significant difference in the incidence of esophageal variceal hemorrhage among the three groups(P>0.05).Conclusion PSE combined with propranolol in the treatment of cirrhosis portal hypertension and esophageal and gastric fundus varices can effectively improve portal and splenic venous blood flow dynamics and reduce inflammatory response.

关 键 词：部分性脾栓塞 普萘洛尔 肝硬化门脉高压 食管胃底静脉曲张 门脉血流动力学 

分 类 号：R575.2[医药卫生—消化系统]