脾切除门奇静脉断流术后肝固有动脉及门静脉的血流动态变化特征  

Hemodynamic characteristics of proper hepatic artery and portal vein in patients after splenectomy and devascularization

作　　者：赵晓飞[1,2] 曾道炳[1,2] 栗光明[1,2] 郭庆良 邸亮 丁兢[1,2] ZHAO Xiaofei;ZENG Daobing;LI Guangming;GUO Qingliang;DI Liang;DING Jing(Department of General Surgery Center,The Capital Medical University-Affiliated YouAn Hospital,Beijing 100069,China;Clinical Center for Liver Cancer,Capital Medical University,Beijing 100069)

机构地区：[1]首都医科大学附属北京佑安医院普通外科中心,北京100069 [2]首都医科大学肝癌临床诊疗及研究中心,北京100069

出　　处：《临床肝胆病杂志》2023年第1期104-109,共6页Journal of Clinical Hepatology

摘　　要：目的了解脾切除门奇静脉断流术后肝固有动脉、门静脉的血流动态变化规律。方法回顾性分析首都医科大学附属北京佑安医院2014年4月—2019年2月收治的103例门静脉高压症行脾切除门奇静脉断流术患者的临床资料,记录患者术前和术后1周、1个月、3个月、6个月、12个月、24个月肝固有动脉、门静脉血流动力学变化数据,进行术前和术后资料对比,分析术前和术后各时间点肝血流变化特征。计量资料符合正态分布时采用配对样本t检验分析术前、术后各指标的差异。结果脾切除门奇静脉断流术后1周、1个月、3个月、6个月、12个月、24个月患者门静脉内径、门静脉流量、门静脉最大流速和平均流速较术前显著下降(P值均<0.05);肝固有动脉流量、流速在术后1周及术后1个月较术前显著增加(P值均<0.05),术后3个月、6个月、12个月、24个月则与术前无显著差异(P值均>0.05)。结论脾切除门奇静脉断流术后门静脉内径、流速、流量较术前明显减低,肝固有动脉流速、流量在术后1个月内增加,术后3个月恢复至术前水平。Objective To investigate the characteristics of hemodynamics of proper hepatic artery and portal vein after splenectomy and devascularization.Methods The clinical data of 103 patients with portal hypertension who underwent splenectomy and devascularization in the Capital Medical University-Affiliated You’an Hospital from April 2014 to February 2019 were retrospectively analyzed.Their hemodynamics of the proper hepatic artery and portal vein were recorded before and 1 week-,and 1-,3-,6-,12-,and 24-months after surgery and then statistically analyzed.Continuous data with normal distribution were compared using paired-samples t test.Results Compared with the before surgery data,the portal vein diameter,portal vein flow,maximum velocity,and average velocity of the portal vein were all significantly decreased 1-week-,1-,3-,6-,12-,and 24-months after splenectomy and devascularization(all P<0.05).The blood flow and velocity of the proper hepatic artery was significantly increased 1 week and 1 month after surgery(all P<0.05);however,there was no statistically significant difference at 3-,6-,12-,and 24-months after surgery.Conclusion The diameter,flow,and flow velocity of the portal vein after splenectomy and devascularization were significantly lower than those before surgery,whereas the proper hepatic artery flow and flow velocity were increased within 1 month after surgery and then returned back to the pre-surgery levels 3 months after surgery.

关 键 词：肝硬化 高血压 门静脉 脾切除门奇静脉断流术 血流动力学 

分 类 号：R657.6[医药卫生—外科学]