改良Sugiura手术对门静脉高压患者肝脏血流动力学及肝功能的影响

Effects of modified surgical procedure on hepatic hemodynamics and hepatic function of portal hypertensive patients

目的了解改良Sugiura手术对门静脉高压患者术后肝血流动力学、肝功能变化及意义。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,评价断流术在门静脉高压症治疗中作用。结果断流术后门静脉压力显著降低,术后1个月、3个月ICG-R15无显著改变(P>0.05),EHBF及PVF在术后1个月、3个月均较术前明显下降(P<0.05)。结论 ICG测定肝储备、肝血流动力学是一种安全、简易且敏感的方法,术后肝储备功能无明显变化;断流术可以维持肝脏血供及肝脏功能,是简单有效合理的手术方式。

【Objective】 To understand the effect and significance of modified surgical procedure on hepatic hemodynamic and hepatic function of portal hypertension.【Methods】 The liver reserve function and effective hepatic blood flow（EHBF） before and after surgery were measured by using retention rate of indocyanine green at fifteen minutes（ICG-R15）,hepatic hemodynamic parameters was measured with hypersound measured after devascularization.【Results】 It was found that portal venous pressure was decrease obviously,the hepatic portal vein and hepatic effective blood flow conspicuous reduced after devascularization 1 month and 3 month（P 0.05）;and hepatic reserve function no significant changes（P 0.05）.【Conclusion】 ICG is a safe,simple and sensitive method on measure liver reserve function,and the liver reserve function no significant changes after devascularization;modified surgical procedure can maintain blood supply of liver and liver function and the operating method is safe,effective and reasonable.