TIPSS术后肝脏血流动力学状态的超声评价

Ultrasonographic study on hepatic hemodynamic changes after transjugular intrahepatic portosystemic stent shunt

目的 探讨经颈静脉肝内门体分流 (TIPSS)术后肝脏血流动力学的改变。方法 采用超声评价 41例肝硬化患者TIPSS术前及术后 1个月的门静脉充血指数 (CI)以及右肝动脉阻力指数 (RI)变化情况 ,以了解肝脏血流动力学状态。结果 术后 1个月患者右肝动脉RI较术前明显减低 (P <0 .0 1) ,门静脉CI较术前显著下降 (P <0 .0 1)。结论 TIPSS术后肝脏血流动力学状态明显改变 :由术前门脉、肝动脉双重供血变为主要由肝动脉代偿供血 ,同时门静脉压力显著降低。超声显像可客观反映这种变化。

Objective To evaluate the hepatic hemodynamic changes after transjugular intrahepatic portosystemic stent shunt(TIPSS)by ultrasonography.Methods The congestion index(CI)of portal vein and the resistant index(RI) of right hepatic artery one month after TIPSS in 41 patients were observed by ultrasonography and compared with those before TIPSS.Results The CI of portal vein and RI of right hepatic artery one month after TIPSS were all markedly decreased than those before TIPSS(P<0.01).Conclusions The hepatic hemodynamics changed a lot after TIPSS.The perfusion of liver mainly depends on hepatic artery supplying after TIPSS,thus before TIPSS it depends on hepatic artery and portal vein.And the portal vein pressure was also decreased after TIPSS.