多普勒导丝评价TIPS术门腔分流道血流特点

Measurement of blood flow volume and its characteristic in the shunt after TIPS with intravascular Doppler guidewire

目的应用血管内多普勒导丝测定TIPS术后门腔分流量及血流特点,提出一种新的、更可靠的检测静脉血流动力学指标的方法。方法 10例门静脉高压患者TIPS术后即刻,使用血管内多普勒导丝测定分流通道内血流速度,结合DSA技术,测出血流量;并予10例正常肝静脉血流作为对照。结果测得TIPS术后分流通道内的平均峰值流速(APV)为(18.51±7.32)cm/s,最大峰值流速(MPV)为(25.93±9.54)cm/s,分流道的直径为(0.80±0.26)cm,门腔分流量为(557.96±94.57)ml/min,并且获得血流频谱特点为波形呈单相,不随心动周期而变化。而肝静脉APV为(15.73±4.52)cm/s;MPV为(26.01±8.33)cm/s;血流量为(654.64±108.56)ml/min,血流频谱特点为波形呈三相,随心动周期而变化。结论利用血管内多普勒导丝能准确而方便地测出TIPS术后门腔分流量并用于评价其血流特点,为检测静脉血流提供了一种新的方法,具有实用性及可行性。

Objective Via the measurement of blood flow volume after TIPS （transjugular intrahepatic portosystemic shunt） with intravascular Doppler guidewire, a novel, reliable method to investigate the hemodynamical parameters of TIPS was tested. Methods With Doppler guidewire, blood flow velocity in the TIPS of 10 patients with portal hypertension were measured, and with the aid of DSA, blood flow volume was obtained. 10 normal hepatic veins were taken as contral. Results After TIPS, some parameters in the TIPS were gained： Average Peak Velocity （APV） was （18.51±7.32） cm/s, Maximum Peak Velocity （MPV） was （25.93±9.54） cm/s, blood flow volumes were （557.96±94.57） ml/ min; and blood flow spectrum was acquired. The wave was nomo-phase in pattern and dischanged with the heart cycle. At the same time, the parameters in hepatic veins were as follows, APV was （15.73±4.52） cm/s;MPV was （26.01±8.33） cm/s blood flow volume was （654.64± 108.56） ml/min. The wave was three-phase in pattern and changed with the heart cycle. Conclusion Accurately and conveniently, blood flow velocity in the TIPS was measured by intravascular Doppler guidewire. The present work on the TIPS in patients illustrated that the novel method is practicable and reliable for measuring the blood flow.