部分脾栓塞术对肝硬化门静脉高压症血液动力学的影响  

Influence of partial splenic embolization to the hemodynamics of portal hypertension of cirrhosis of the liver

作　　者：费志勇[1] 张志娟[1] 陈兴田[1] 彭文洪[1] 伦知见[1] 沈玉法[1] 王瑞武[1] 田峰[1] 

机构地区：[1]山东省临沂市沂水中心医院,山东临沂276400

出　　处：《河北医学》2004年第3期228-231,共4页Hebei Medicine

摘　　要：目的 :研究部分脾栓塞术 (PSE)对肝硬化门静脉高压症血液动力学的影响。方法 :6 8例肝硬化门静脉高压症并脾功能亢进患者 ,经股动脉插管对部分脾动脉用明胶海绵颗粒进行栓塞 ,应用彩色多普勒超声仪测量PSE前、后门静脉主干 (MPV)、脾静脉 (SV)内径及血流速度的变化 ,观察血流量的变化。结果 :PSE术后MPV内径由 1 .5 6± 0 .1 6cm减至 1 .38± 0 .1 9cm(p <0 .0 1 )。SV内径由 1 .2 7± 0 .2 0cm减至 0 .96± 0 .2 4cm(p <0 .0 1 )。MPV血流速度由 1 4 .39± 3.9cm .s-1 减至 1 2 .3± 4 .2cm .s-1 (p<0 .0 1 )。SV血流速度由 1 6 .7± 4 .4cm .s-1 减为 1 1 .6± 3.9cm .s-1 (p <0 .0 1 )。MPV血流量由 1 5 36±2 85ml.min-1 降至 1 1 31± 30 1ml.min-1 (p <0 .0 1 )。SV血流量由 1 0 4 7± 2 6 8ml.min-1 降至 5 46± 2 1 3ml.min-1 (p <0 .0 1 )。结论 :PSE后门脉主干及脾静脉内径较PSE前缩窄 ,血流速度减慢 ,门脉血流量减少 ,门脉压力降低。Objective: Research the influence of partial splenic embolization(PSE)to the hemodynamics of portal hypertension of cirrhosis of the liver. Methods: Using gelatin sponge to embolism the spleen arteries of 68 patients,who suffering from portal hypertension of cirrhosis of the liver and hypersplenism.We measured the inside of main branch of portal vein(MPV),spleen vein(SV) and rate of blood flow by color doppler ultrasonography before PSE and after PSE. Results: After PSE,the inside diameter of MPV decreased from 1.56±0.16cm to 1.38±0.19cm(p<0.01),while the inside diameter of SV decreased from 1.27±0.20cm to 0.96 ±0.24cm(p<0.01).The rate of blood flow of MPV slowed down from 14.39±3.9cm.s -1 to 12.3±4.2 cm.s -1 (p<0.01),while the rate of blood flow of SV slow down from 16.7±4.4 cm.s -1 to 11.6±3.9 cm.s -1 .The volume of blood flow of MPV reduced from 1536±285ml.min -1 to 1131±301 ml.min -1 ,while the volume blood flow of SV reduced from 1047±268 ml.min -1 to 546±213 ml.min -1 (p<0.01).Conclusion: The inside diameter of MPV and SV contracted,the rate of blood slowed down,the volume of blood flow reduced and the pressure of PV dropped after PSE.

关 键 词：部分脾栓塞术 肝硬化 门静脉高压症 血液动力学 

分 类 号：R575.2[医药卫生—消化系统]