精确测定门腔“H”型分流术有效分流比和最佳分流口径选择的实验研究

Precise measurement of effective shunt ratio and determination of optimal shunt diameter in "H" portal-cavity shunt in dogs

作者利用自己设计制作的微米缩窄器,在狗实验性肝硬变门脉高压症模型上行门腔“H”型分流时精确测定分流血管及门静脉内径,以探讨有效分流比(ESR:分流血管内径/门静脉内径)与最佳分流口径。结果表明:①应用微米缩窄器精确控制有效分流比的方法可靠、方便,血流动力学指标稳定;②当有效分流比在0.93～0.98时,门脉压力降至2.46±0.13 kPa,全肝血流减少小于30％,门腔压力梯度为1.05±0.27kPa,均大于0.98 kPa。此时的分流口径为最佳分流口径。

A micrometer constrictor designed by the authors was employed for postacaval "H" type shunt in dogs with experimental hepatic cirrhosis and precise measurement of internal calibre of shunt vessel and the portal vein and determination of effective shunt ratio and optimal shunt calibre were also carried out. The findmgs showed that adjustment of effective shunt ratio by the constrictor was reliable and convenient; moreover, hemodynarmc parameters were stable. When effective ratio ragned from 0. 93 to 0. 98, portacaval pressure fell to 2. 46⒈0. 13 kPa, hepatic blood flow decreased 30% and portacaval pressure gradient was 1. 05⒈0. 27 kPa, which was higher than 0. 98 kPa; the shunt caliber thus obtained was the optimal shunt caliber.