脾切除门奇静脉断流术对门静脉高压症患者肝脏血液动力学的影响  

Effects of Splenectomy and Portal-azygous Disconnection on Hepatic Hemodynamics

作　　者：徐力善[1] 兰晓东[1] 许军[2] 丁红 

机构地区：[1]黑龙江省医院普外科,黑龙江哈尔滨150036 [2]哈尔滨医科大学第一临床医学院,黑龙江哈尔滨150001 [3]黑龙江省第二医院超声科,黑龙江哈尔滨150010

出　　处：《黑龙江医学》2003年第2期88-89,共2页Heilongjiang Medical Journal

摘　　要：目的　观察脾切除门奇静脉断流术 (断流术 )对门静脉高压症肝血液动力学变化的影响。方法　应用超声多普勒分别检测 2 5例门静脉高压症患者手术前后门静脉血流量 (PVF)、肠系膜上静脉血流量 (SMVF)、脾静脉血流量 (SVF)的变化 ,采用水柱法测量自由静脉压力 (FPP)的变化。结果　PVF由术前的 (84 9± 2 4 1)ml/min减少至术后 (6 70± 132 )ml/min ;SMVF由术前的 (44 8± 112 )ml/min增加至术后 (5 91± 4 8)ml/min。FPP由术前的 (3 37± 0 6 3)kPa降至术后 (3 0 0± 0 73)kPa。结论　断流术有效地缓解了门静脉系统的高动力循环状态。但断流术后门静脉入肝血流更加减少 。Objective To investigate the effect of splenectomy and portal-azygous disconnection on hepatic hemodynamics. Methods The portal venous flow (PVF), superior mesenteric vein flow (SMVF) and splenic vein flow (SVF) were measured with Doppler ultrasonic instrument in 25 patients with portal hypertension. The free portal venous (FPP) was measured by manometic method. Results It was found that PVF was decrease from (849±241)ml/min preoperatively to (670±132)ml/min; SMVF was increased from (448±112)ml/min preoperatively to (591±48)ml/min. FPP was decreased from (3.37±0.63) kPa preoperatively to (3.00±0.73) kPa.Conclusion Splenectomy and portal-azygous disconnection effect a decrease on hepatopetal blood inflow which is unfavorable to the maintenance of liver function.

关 键 词：外科学 门静脉高压断流术 脾切除 多普勒超声检查 血液动力学 自由静脉压力 

分 类 号：R657.34[医药卫生—外科学]