Budd-Chiari综合征肝脾形态学和门静脉及脾血流动力学研究

Ultrasonogram of liver and spleen and hemodynamics of spleen and portal vein in patients with Budd-Chiari syndrome

目的 研究Budd -Chiari综合征肝脾形态学及门静脉、脾动静脉血流动力学改变。方法 应用彩色多普勒超声检测 112例正常人、12 6例Budd -Chiari综合征患者门静脉主干及脾动静脉血管内径、流速、流量及脾动脉阻力指数 ,并常规切面测量肝脾大小。结果 Budd -Chiari综合征患者与正常人相比 :①门静脉主干及脾动静脉血管内径、脾动静脉血流速度及流量均较大 (P <0 0 5 ) ;②门静脉入肝血流速度及流量较小 (P <0 0 5 ) ;③Budd -Chiari综合征患者肝脾增大 ,肝尾状叶显著增大 (P <0 .0 1)。结论 ①Budd -Chiari综合征由于肝血液回流受阻 ,肝增大 ,门静脉入肝血流速度减慢 ,流量减少 ;②脾增大 ,脾血流量增加 ,脾处于高动力循环状态。Budd -Chiari综合征患者术前检测门脉及脾血流动力学改变对于术前评估肝脾血流动力学状况。

Objective To study the changes in the morphology of liver and spleen and the hemodynamics in the portal vein and splenetic vessel in Budd-Chiari syndrome (BCS). Methods The sizes of liver and spleen were measured by routine ultrasonography in 126 cases of BCS and 116 normal controls. Duplex color system was employed to determine the hemodynamic parameters. Results ①The diameters of the portal vein and splenetic vessels, the velocity and amount of blood flow in these vessels were increased in BCS group as compared with the control (P<0.05). ②The blood flow of the portal vein into the liver was less than normal. ③The patient's liver and spleen were enlarged, especially the caudate lobe of the liver (P<0.01). Conclusions ①Retardation of the venous flow from the liver may result in hepatomegaly and decreased portal blood flow. ②Splenomegaly and increased blood flow indicates a high level of hemodynamics in the spleen. Preoperative estimation of the portal and splenetic hemodynamics in BCS is of value in deciding the surgical procedures beforehand and assessing the therapeutic results of the treatment afterwards.