彩色多普勒超声评价奥曲肽对肝硬化门脉高压症断流术后的血流动力学影响

Effects of octreotide on hepatic hemodynamics in cirrhotic patients with portal hypertension using color Doppler ultrasound technique

目的应用彩色多普勒超声研究奥曲肽对肝硬化门静脉高压症患者脾切除加断流术后血流动力学的影响。方法肝硬化门静脉高压症行脾切除加门奇静脉断流术患者28例，分别于术前，术后1周及静滴奥曲肽72h后应用彩色多普勒超声测定门静脉及肝动脉内径、最大血流速度、平均血流速度、血流量参数。结果术前与术后1周比较，门静脉流速、血流量参数差异有显著性（P〈0．01），且肝动脉流速及血流量增加（P〈0．01）；静滴奥曲肽72h后与术后1周比较，门静脉最大流速、平均流速、血流量参数均降低，差异有显著性（P〈0．05．0．01）。结论奥曲肽可降低断流术后患者门静脉血流量参数及血流速度。彩色多普勒超声测定门静脉血液动力学指标可间接估测门脉压力，作为无创评价药物治疗门脉高压的方法。

Objective The study is to investigate the effect of octreotide on hemodynamics by means of color Doppler ultrasound technique in patients with liver cirrhosis and portal hypertension after splenectomy and portal ＆ azygous vein devascularization. Methods We selected 28 patients with liver cirrhosis and portal hypertension after their splenectomy and portal ＆ azygous vein devascularization. Color doppler ultrasound technique was employed at preoperative, lw after operation and 72hr after octreotide i. v to assay portal vein and hepatic artery＇ s bore, the peak velocity, average velocity and blood flow parameter. Results There is significant difference between portal vein flow rate and blood flow parameter at postoperative 1 week in contrast to preoperative（ P 〈 0.01） while peak velocity and blood flow parameter in hepatic artery increased significantly （ P 〈 0.01 ） ; And there is significant difference when comparing 72 hr after octreotide i. v with 1 week after operation, we found peak velocity in portal vein, average velocity and blood flow rate decreased remarkably （ P 〈 0.05 - 0.01）. Conclusion It showed that octreotide could decrease blood flow in portal vein, andthat color Doppler ultrasound technique can serve as a noninvasive method in estimating of drug treatment.