介入性门脉断流术对肝硬化门脉高压症患者血流动力学的影响

Study on the effect of interventional portal devascularization on hemodynamics in patients with liver cirrhosis and portal hypertension

目的探讨介入性门脉断流术对肝硬化门脉高压症患者血流动力学的影响。方法随机选择2011年9月至2013年9月收治的肝硬化门脉高压症患者中54例,均实施介入性门脉断流术,观察患者术前、术后的血流动力学变化情况。结果经皮经肝胃食管曲张静脉栓塞术(PTVE)术后,较之术前,患者的门静脉压(FPP)出现显著上升的情况,差异有统计学意义(P<0.05);联合性断流术后,较之术前,患者的FPP比较差异无统计学意义(P>0.05)。术后患者的门静脉相关血流动力学未出现显著变化,但脾静脉血流速度和血流量较术前均显著降低,内径较之术前显著缩小,经比较差异均有统计学意义,(均P<0.01,P<0.05)。结论介入性门脉断流术对肝硬化门脉高压症患者血流动力学产生一定的影响。

Objectine To explore the influence of interventional portal devascularization on hemodynamics in patients with liver cirrhosis and portal hypertension. Methods A total of 54 patients with liver cirrhosis and portal hypertension in this hospital during September 2011 to September 2013 were allocated in this study,and they were given with interventional portal devascularization,and the hemodynamic changes in these patients were observed after this procedure. Results The FPP of patients was significantly increased after PTVE compared with that of preo-peration,the difference was statistically significant（ P ﹤ 0. 05）. The FPP in patients with combined devascularization compared with that of preo-peration had no statistically significant difference（ P ﹥ 0. 05）. There was no significant change occurred in hemodynamics of portal vein in postop-erative patients,but the velocity and amount of blood flow were significantly decreased,and the diameter of splenic vein compared with that before operation had significantly been reduced,and the difference was statistically significant（all P ﹤ 0. 01,P ﹤ 0. 05）. Conclusion The interven-tional portal devascularization has certain influence on hemodynamics in patients with liver cirrhosis and portal hypertension.