彩色多普勒超声对终末期肝硬化患者肝移植术前后脾静脉血流动力学变化的观察

Use Color Doppler Imaging to Observe the Changes of Blood Flow Dynamics of Spleen Vein after Liver Transplant in Patients with Hepatocirrhosis and Hypersplenism

目的比较终末期肝硬化患者肝移植手术前后脾静脉血流动力学的变化,为评价肝移植术中是否保留脾脏提供依据。方法应用彩色多普勒超声测量术前及术后第1、2、4周测量28例肝硬化合并脾亢患者脾脏的长径、厚径及脾门静脉管径、平均血流速度及峰值血流速度等并进行比较。同时期测量患者肝固有动脉管径及峰值血流速度、门静脉管径及血流速度。结果术后患者脾脏缩小、脾门静脉平均血流速度及峰值血流速度、门静脉血流速度增加,与术前相比有统计学差异(P<0.05)。结论肝移植术后脾脏的异常变化得到部分改善,这些改善是否继续或有反复仍需进行长期的观察和研究。

Objective In order to make the decision to whether spleen can be kept or not in liver transplant, we compare changes of blood flow dynamics of spleen vein before operation with that of after operation. Methods For 28 patients with hepatocirrhosis and hypersplenism, we use color Doppler flow imaging to measure the length and thickness of spleen, width and blood flow velocity of spleen vein before liver transplant, compared with that at 1st week, 2nd week and 4th week after operation. At the same time width and blood flow velocity of liver artery in portae of liver,width and blood flow velocity of portae vein were also measured. Results After liver transplant ,the volume of spleen decreased, the average bl, od flow velocity of spleen vein increased. These changes were different significantly when compared with that of before operation （P〈0.05）. Conclusions After liver transplant, the symptom of hypersplenism may be partially improved. But whether these good changes will go on or not still depend on permanent observing and studying.