断流术对门静脉高压症肝脏血液动力学及肝储备功能的影响

Devascularization of liver with portal hypertension hemodynamics and liver reserve function

目的:了解门静脉高压患者肝储备功能、有效肝血流与肝功能关系,及断流术前后肝储备功能、肝血流动力学变化及意义。方法:用ICG-R15检测肝储备功能及肝脏有效血流(EHBF),B超测定断流术前后的肝脏血流动力学,评价断流术在门脉高压症治疗中作用。结果:Child-Pugh分级与ICG-R15、EHBF有良好的相关性;断流术后肝门静脉血流及有效血流量显著减少。结论:ICG测定肝储备、肝血流动力学是一种安全、无创、简易且敏感的方法,断流术后肝储备功能没有明显变化,断流术对于减少肝血流量有重要作用。

Objective：Understanding the effect and significance in devascularization of hepatic hemodynamics and liver reserve function of portal hypertension,and compare the relationship with it. Methods：To test liver reserve function and effective hepatic blood flow（EHBF） before and after surgery by using retention rate of indocyanine green at fifteen minutes（ICG-R15）,hypersound measured hepatic hemodynamic parameters after devascularization,to investigate the change that dynamics of blood flow and liver functional reserve after treat portal hypertension in devascularization. Results：The hepatic portal vein and hepatic effective blood flow conspicuous reduced after devascularization;and hepatic reserve function no significant changes;Child-Pugh classification and ICG-R15,EHBF have favourable correlation. Conclusion：The liver reserve function no significant changes after devascularization,it plays an important role in reduce liver blood flow and protect the liver reserve function,and this operating method is safe and effective.