肝中静脉和肝右静脉行肝静脉压力梯度测定的对比

Comparison of catheterization in middle hepatic vein and right hepatic vein for hepatic venous pressure gradient

目的观察和比较肝中静脉和肝右静脉行肝静脉压力梯度测定的操作成功率及插管透视时间。方法采用前瞻性研究方法,选取2017年11月至2019年12月于首都医科大学附属北京友谊医院行经颈内静脉路径球囊法测定肝静脉压力梯度的27例患者,分别于肝中静脉和肝右静脉行压力梯度测定,分别观察肝中静脉和肝右静脉的插管成功率和所需插管透视时间。结果肝中静脉置管成功率(26/27,96.30%)明显高于肝右静脉(18/27,66.67%),肝中静脉球囊导管置管平均插管透视时间(187±28)s明显少于肝右静脉(256±33)s,上述差异均具有统计学意义(P<0.05)。结论在经颈静脉路径球囊导管肝静脉压力梯度测量中,肝中静脉相对于肝右静脉,是更加便捷的血管路径,应该作为首选插管静脉支。

Objective To study and compare the success rate and fluoroscopy time of catheterization in middle hepatic vein and in right vein for hepatic venous pressure gradient.Methods A prospective study was performed.Twenty-seven patients who underwent transjugular measurement of hepatic venous pressure gradient(HVPG)in Beijing Friendship Hospital,Capital Medical University.from November 2017 to December 2019.Balloon catheter was used to measure HVPG in middle hepatic vein and right hepatic vein respectively.The success rate and fluoroscopy time of catheterization in middle hepatic vein and right hepatic vein were observed.Results The success rate of catheterization in middle hepatic vein(26/27,96.30%)was significantly higher than that in right hepatic vein(18/27,66.67%),and the mean fluoroscopy time of catheterization in middle hepatic vein(187±28)s was significantly lower than that in right hepatic vein(256±33)s.All the above differences were statistically significant(P<0.05).Conclusion The middle hepatic vein is a more convenient vessel than the right hepatic vein for transjugular HVPG with balloon catheter,and should be catheterized as the first choice.