介入断流术后门静脉动力学动态变化研究

The study of changes of the portal vein hemodynamics after interventional disconnection

目的:观察介入断流术后门静脉系统血流动力学动态变化。方法:对106例介入断流术病人术中测门静脉压力,术前及术后检测门静脉系统血流动力学及相关指标。结果:术后自由门静脉压(32.98±7.20cmH2O)较术前(38.44±7.40cmH2O)明显降低,平均下降14.20%,术后1周门静脉、脾静脉、肠系膜上静脉血流量(分别为797.11±309.55ml/min、643.40±304.58ml/min、737.18±258.00ml/min)较术前(分别为993.53±409.92ml/min、900.41±317.83ml/min、807.90±287.98ml/min)明显下降,而后逐渐回升,术后半年门静脉血流量(840.99±331.46ml/min)较术前无显著差异。结论:介入断流术即胃冠状静脉TH胶栓塞+部分脾动脉栓塞能有效地降低门静脉压力及门静脉血流量,为食管胃底静脉曲张的临床治疗提供理论依据。

Objective：To examine changes in the portal vein hemodynamics of tile 106 patients after intervenfionnl disconnection （percutaneous transhepafic fixed TH glue and partial splenic embolization） for cirrhotic portal hypertention .Methods： 106 patients with cirrhotic portal hypertention underwent interventional disconnection. Values of hemodynamic indexs of portal venous system, the blood routine examination and hepatic function were obtained before and after embolization, and the results were dealed with statistical treatment.Results： The free pressure of the portal vein droped from 38.44 ± 7.40cmH20 to 32.98±7.20cmH20 after interventional obliteration （ P 〈 0.05）, the decline ratio is 14.20%. The blood flow of the portal vein,splenic vein and superior mesenteric vein were evaluated with color Doppler ultrasonography, respectively, 993.53 ± 409.92 ml/inin, 900.41± 317.83ml/min, 807.90 ± 287.98rid/rain before the operation and respectively 797.11 ± 309.55ml/min, 643.40 ± 304.58ml/min, 737.18 ± 258.00ml/min after a week of the operation. Then they ascended gradually. The blood flow of the portal vein evaluated 6 months after embolization was 840.99 ± 331.46 ml/min, and the difference was not statistically significant compared to the blood flow of the portal vein before operation. Conclusion： The tntervenfional discomection, which can effeetorely decrease protal hypertensoon and blood flow, prowde the theorg for the therapy of the gastroesophayeal varoices.