摘要
目的应用彩色多普勒超声研究门静脉高压症患者脾切除及贲门周围血管离断术后肝脏血流动力学的变化情况。方法彩色多普勒超声动态监测30例门静脉高压症患者术前1 d及术后第3、7、30天肝脏血流参数,包括门静脉内径、门静脉最大流速、门静脉血流量、肝固有动脉内径、肝固有动脉收缩期峰值流速和舒张末期流速、肝固有动脉阻力指数及肝固有动脉血流量;以上各参数均测量3次取其平均值,手术前后测量自由门静脉压力。结果所有患者门静脉内径术后第7天、第30天较术前均减小,门静脉最大流速术后第7天、第30天较术前均降低,门静脉流量术后第3天较术前减少,差异均有统计学意义(均P<0.05);术后肝固有动脉收缩期峰值流速、舒张末期流速及流量均较术前增加,术后阻力指数较术前降低,差异均有统计学意义(均P<0.05)。术前与术后各时间段肝固有动脉内径比较差异无统计学意义;术后自由门静脉压力较术前降低。结论彩色多普勒超声可监测门静脉高压症患者脾切除加断流术术后肝脏血流动力学变化,能够为临床疗效的判断提供可靠依据,具有重要的临床价值。
Objective To study the postoperative liver hemodynamic changes in patients with portal hypertension splenectomy plus cardia peripheral vascular amputation using CDFI.Methods Using CDFI technique to monitor the portal vein diameter,portal vein maximum velocity,portal venous flow,the proper hepatic artery diameter,hepatic artery peak systolic velocity,end-diastolic velocity resistance index,and proper hepatic artery blood flow in 30 patients with portal hypertension before 1 d,and 3 d,7 d,and 30 d after surgery,all these parameters were measured three times to get average values. The preoperative and postoperative free portal vein pressure（FPP）were measured.Results The portal vein diameter reduced in all patients at 7 d and 30 d after surgery,there was significant difference（all P〈0.05）,the maximum flow velocity of portal vein reduced at 7 d and 30 d after surgery,there was significant difference（all P〈0.05）,the portal venous flow at 3 d after surgery decreased,there was significant difference（all P〈0.05）,the peak velocity of proper hepatic artery,end-diastolic velocity and proper hepatic artery blood flow increased after surgery,there was significant difference（all P〈0.05）,RI reduced after surgery,there was significant difference （P〈0.05）. There was no significant difference of diameter of the proper hepatic artery before and after surgery,the FPP reduced after surgery.Conclusion CDFI has a great value in monitoring the changes of liver hemodynamics in patients with splenectomy plus cardia peripheral vascular amputation and deserves further study to provide a reliable basis for clinical efficacy.
出处
《临床超声医学杂志》
2016年第5期304-307,共4页
Journal of Clinical Ultrasound in Medicine
