肝动脉鞘切除术对门静脉高压症肝动脉血流量影响的研究

The effect of neunectomy of common hepatic artery in patients with protal hypertension on the hepatic artery blood flow.

因肝硬化门静脉高压择期行脾切除门奇断流术２０例按入院先后分为两组（各１０例）。加肝总动脉鞘切除作处理组。术前、术后２周、术后３个月用超声多普勒观测肝固有动脉、门静脉血流量。处理组术后２周肝固有动脉血流量较术前增加３０％，术后３个月仍维持较术前增加１８％的量，最高可达４０％。病人住院时间较对照组平均少５天。门静脉主干血流量未受肝固有动脉血流量增加的影响。门奇断流术不减少病人肝门静脉血流量，手术中加作肝总动脉鞘切除不特别增加病人的手术负担，作为一种有益于肝功能的附加手术是值得推荐的。

The improvement of blood supply of hepatic cells is an important factor to maintain impaired hepatic function.Neunectomy has been proved to be an effective procedure in a series of 20 patients,who had suffered from portal hypertension following hepatitis B and underwent portal azygous disconnection combined with splennectomy.Neunectomy has been added in 10 patients alternatively according to the admisson date(management group:N the rest 10 patients as control C group.The alternation of blood flow of proper hepatic artery and main trunk of portal vein has been monitored 2 weeks,3 months postoperatively.The proper hepatic artery blood flow increased by 30%(P<0 05 and 18% respectively than before operation in the management group,while the blood flow of proper hepatic artery in the control group in only 3% more and even lower respectively than before.The increase of portal vein blood flow after operation did not shouw significant both in the N and C group.The clinical results in N group is satisfied the hospitaliztion is 5 days less in N group than in C group in average.The neunectomy of common hepatic artery in cirrhotic patient is justified.