彩色多普勒超声观测肝硬化门脉高压症伴脾亢部分脾栓塞术前后血流动力学改变

Hemodynamic changes observed by color Doppler ultrasonography in liver cirrhosis with portal hypertension and hypersplenia before and after partial splenic embolization

目的 探讨彩色多普勒超声观测肝硬化门脉高压症伴脾功能亢进 (简称脾亢 )患者行部分脾栓塞术 (PSE)的临床应用价值。方法 选择 30例肝硬化门脉高压症伴脾亢患者作部分脾栓塞术 (PSE) ,于PSE前后用彩色多普勒超声观测脾静脉与门静脉的血流动力学改变及脾脏的体积改变 ,作自身对照研究。结果 与术前相比 ,术后 1周的脾静脉、门静脉的内径缩小(P <0 .0 0 1) ,平均血流量降低 (P <0 .0 0 1) ,脾脏的厚度及长径无明显差异 (P >0 .0 5 ) ;术后 1月的脾静脉、门静脉的内径进一步缩小 (P <0 .0 0 1) ,平均血流量进一步降低 (P <0 .0 0 1) ,脾脏的厚度及长径明显变小 (P <0 .0 0 1)。结论 PSE可减少脾静脉及门静脉的血流量 ,缩小脾脏的体积 ,应用彩色多普勒超声技术评价肝硬化门脉高压症伴脾亢患者的PSE疗效是一种直观而准确的方法。

Objective To investigate the clinical application of color Doppler ultrasonography in the patients of liver cirrhosis with portal hypertension and hypersplenia in osberving the hemodynamic changes before and after partial splenic embolization(PSE).Methods 30 patients of liver cirrhosis with portal hypertension and hypersplenia were treated by partial splenic embolization(PSE).Before and after the operation,all patients' hemodynamic changes of splenic and portal veins,and the volume changes of the spleen were measured by color Doppler ultrasonography. Then the results were studied by self comparison.Results In 1 week after the operation, the inner diameters of splenic and portal veins were narrower(P<0.001),and the mean volume of venous reduced(P<0.001)compared with those preoperative values,but the thickness and length of spleen did not change appreciably. In 1 months after the operation, the inner diameters of splenic and portal veins were further narrowed(P<0.001),and the mean volume of venous were further redudced(P<0.001). The thickness and length of spleen were reduced appreciably(P<0.001).Conclusion PSE can reduce volume of venous in splenic and portal veins ,and reduce volume of spleen. It is a straight and accurate way to evaluate the curative effect of PSE in the patients of liver cirrhosis with portal hypertension and hypersplenia by color Doppler ultrasonography.