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症状性大脑中动脉粥样硬化性狭窄的血流动力学数值模拟研究 被引量:8
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作者 沈雷 张永巍 +2 位作者 吕楠 黄清海 邓本强 《中国卒中杂志》 2016年第1期54-60,共7页
目的探讨血流动力学因素在大脑中动脉粥样硬化性狭窄患者急性脑缺血事件中的作用。方法收集10例第二军医大学附属长海医院脑血管病中心收治的症状性单侧大脑中动脉(middle cerebral artery,MCA)M1段局限狭窄的患者,依据脑血管造影建立... 目的探讨血流动力学因素在大脑中动脉粥样硬化性狭窄患者急性脑缺血事件中的作用。方法收集10例第二军医大学附属长海医院脑血管病中心收治的症状性单侧大脑中动脉(middle cerebral artery,MCA)M1段局限狭窄的患者,依据脑血管造影建立病例特异三维数值模型,测量M1段狭窄程度,并应用计算机流体力学方法测算血流动力学参数,分析动脉不同部位及不同狭窄程度血流动力学参数的变化。狭窄段至远端正常血管段壁面剪切力(wall shear stress,WSS)变化用标准化WSS表示,为狭窄段WSS(WSS_s)与远端正常血管段WSS(WSS_p)的比值,记为WSS_(S/P);血流速度(velocity)及震荡剪切指数(oscillatory shear index,OSI)的变化用标准化的velocity_(S/P)、OSI_(S/P)表示。结果 MCA狭窄段WSS明显高于远端正常段(中位数81.85 vs 18.81,P=-0.000);狭窄段流速快于远端正常段(中位数2.26 vs 0.33,P=-0.000);而MCA最狭窄处OSI低于远端正常血管段(中位数0.00039vs 0.015 70,P=0.000);不同狭窄程度间,标准化血流动力学参数不同;狭窄程度增大,WSS_(S/P)、velocity_(S/P)增加(r_s=0.828,P=-0.003;r_s=0.79,P=-0.007),OSI_(S/P)逐渐下降(r_s=-0.822,P=-0.004)。结论大脑中动脉狭窄病变伴有血流动力学改变,血流动力学因素可能参与了颅内动脉粥样硬化形成和发展。 展开更多
关键词 大脑中动脉 狭窄 计算机血流动力学 脑血管事件
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Comparison of percutaneous transhepatic portal vein embolization and unilateral portal vein ligation
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作者 Hiroya Iida Tsukasa Aihara +2 位作者 Shinichi Ikuta Hidenori Yoshie Naoki Yamanaka 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第19期2371-2376,共6页
AIM: To compare the effect of percutaneous transhepatic portal vein embolization (PTPE) and unilateral portal vein ligation (PVL) on hepatic hemodynamics and right hepatic lobe (RHL) atrophy.METHODS: Between M... AIM: To compare the effect of percutaneous transhepatic portal vein embolization (PTPE) and unilateral portal vein ligation (PVL) on hepatic hemodynamics and right hepatic lobe (RHL) atrophy.METHODS: Between March 2005 and March 2009, 13 cases were selected for PTPE (n = 9) and PVL (n = 4) in the RHL. The PTPE group included hilar bile duct carcinoma (n = 2), intrahepatic cholangiocarcinoma (n = 2), hepatocellular carcinoma (n = 2) and liver metastasis (n = 3). The PVL group included hepatocellular carcinoma (n = 2) and liver metastasis (n = 2). In addition, observation of postoperative hepatic hemodynamics obtained from computed tomography and Doppler ultrasonography was compared between the two groups.RESULTS: Mean ages in the two groups were 58.9 ± 2.9 years (PVL group) vs 69.7 ±3.2 years (PTPE group), which was a significant difference (P = 0.0002). Among the indicators of liver function, including serum albumin, serum bilirubin, aspartate aminotransferase, alanine aminotransferase, platelets and indocyanine green retention rate at 15 min, no significant differ- ences were observed between the two groups. Preop-erative RHL volumes in the PTPE and PVL groups were estimated to be 804.9 ±181.1 mL and 813.3 4±129.7 mL, respectively, with volume rates of 68.9% ± 2.8% and 69.2% ±4.2%, respectively. There were no significant differences in RHL volumes (P = 0.83) and RHL volume rates (P = 0.94), respectively. At 1 mo after PTPE or PVL, postoperative RHL volumes in the PTPE and PVL groups were estimated to be 638.4±153.6 mL and 749.8 ± 121.9 mL, respectively, with no significant difference (P = 0.14). Postoperative RHL volume rates in the PTPE and PVL groups were estimated to be 54.6% ± 4.2% and 63.7% ± 3.9%, respectively, which was a significant difference (P = 0.0056). At 1 mo after the operation, the liver volume atrophy rate was 14.3% ± 2.3% in the PTPE group and 5.4%± 1.6% in the PVL group, which was a significant difference (P = 0.0061).CONCLUSION: PTPE is a more effective procedure than PVL because PTPE is able to occlude completely the portal branch throughout the right peripheral vein. 展开更多
关键词 Percutaneous transhepatic portal vein em-bolization Portal vein ligation Liver atrophy Futureliver remnant Two-stage hepatectomy
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