三维成像技术和超声多普勒联合观察门脉高压症门静脉血流的变化

Observation of portal hemodynamic changes in portal hypertension with three—dimessional imaging technique and ultrasonic Doppler

本文采用计算机图像分析技术和超声多普勒检测了正常者和肝硬变门脉高压症(CPH)患者肝脏体积和门静脉血流,研究了肝脏体积、功能与门静脉血流变化的关系以及联合门奇断流术前、后门静脉血流的变化。结果示 CPH 患者肝脏体积缩小(P<0.05)、门静脉主干内径增宽(P<0.01)、流速减慢(P<0.05)、血流量增大(P<0.05)、PVF/LV 显著增加(P<0.01),肝脏体积缩小和 PVF/LV 增加以 Child B 级患者最为明显;联合门奇断流术后门静脉主干内径明显缩小(P<0.01)、流速显著减慢(P<0.01)、血流量显著减少(P<0.01);术后4～18个月随访,门静脉血流逐渐恢复,接近手术前水平。

Computer imaging analytic technique and ultrasonic Doppler were used to evaluate the liver volume and the portal blood flow in normal subjects and the subjects with cirrhostic portal hypertension.The relations among liver volume,hepatic function and portal blood flow was researched.In addition,the portal hemodynamic changes before and after combined portozygos disconnection were observed.The results showed that the liver volume decreased(P<0.05),the diameter of portal main trunk significantly decreased(P<0.01),the portal blood velocity slowed(P< 0.05),the portal blood flow growed(P<0.05)and PVF/LV significantly inereased(P<0.01)in the subjects with the cirrhostic portal hypertension.The decrease of liver volume and increase of PVF/ LV were remarkable in the cirrhostic patients with Child classification B.After an operation,the decrease of portal main trunk diameter,the slow of portal blood velocity and the reduction of the portal blood flow were significantly observed.During the following 4～18 months,the portal blood flow gradually recovered and was close to the level of the portal blood flow before the operation.