门奇联合断流术对门脉高压血液动力学的影响

EFFECTS OF ESOPHAGOGASTRIC DEVASCULARIZATION COMBINED WITH SPLENECTOMY AND ESOPHAGEAL TRANSECTION ON PORTAL AND SYSTEMIC HEMODYNAMICS

目的 了解门奇联合断流术对门脉高压症 (PHT)患者血液动力学的影响。方法 门脉高压症患者 16例 ,于门奇联合断流术中测定开腹、脾动脉结扎、脾切除、贲门周围血管离断及食管下段横断后自由门静脉压 (FPP)、中心静脉压(CVP)、心输出量 (CO)、心率 (HR)及平均动脉压 (MAP)。结果 脾动脉结扎、脾切除、贲门周围血管离断及食管下段横断后FPP显著下降 (P<0 .0 1) ,而 CVP、CO、HR、MAP无明显变化 (P>0 .0 5 )。结论 门奇联合断流术能显著降低自由门静脉压 。

Objective To investigate the effects of esophagogastric devascularization combined with splenectomy and esophageal transection on portal and systemic hemodynamics.Methods The data from 16 patients were studied.Free portal pressure(FPP),central vein pressure(CVP),cardiac output(CO),heart rate(HR)and mean artery pressure(MAP)were measured following laparotomy,splenic artery ligation,splenectomy,devascularization and esophageal transection.Results After laparotomy,splenic artery ligation,splenectomy,devascularization and esophageal transection,FPP was significantly decreased(P<0.01),but CVP,CO,HR and MAP was unchanged(P>0.05).Conclusion The nonshunting operation can significantly decrease FPP,but has no effect on systemic hemodynamics.