乙肝后肝硬化脾功能亢进患者部分性脾脏栓塞术后血流动力变化初步研究

目的观察肝硬化门静脉高压伴脾功能亢进患者部分性脾脏栓塞术（PSE）在术前、术后肝动脉、脾动脉及门静脉血流动力学变化,探讨PSE对门静脉高压治疗的效果。方法 42例肝硬化门静脉高压伴脾亢患者接受PSE治疗,利用彩色多普勒超声分别于PSE术前及术后检测肝动脉、脾动脉、脾静脉及门静脉血管内径,平均血流速度、血流量和动脉血管阻力。用统计学方法分析术前、术后各项观察指标的变化。结果 PSE术后肝动脉血流速度、血流量较术前增加,脾动脉、脾静脉及门静脉血管内径及血流速度及血流量较术前减少,P〈0.05,差异有统计学意义。结论 PSE术后肝动脉血流量增加,脾动脉、脾静脉血流量减少,可缓解脾循环高动力状态,间接降低门静脉压力。

Preliminary Study on Partial Splenic Artery Embolization Postoperative Hemodynamic Changes in Patients with Hepatitis Cirrhosis of the Liver Function of Spleen Hyperfunction

Objective To observe patients with liver cirrhosis portal hypertension associated with hypersplenism in partial splenic artery embolization （PSE） preoperative and postoperative hemodynamics changes of the hepatic artery, splenic artery and portal venous system, to explore the effect of PSE on portal hypertension treatment. Methods 42 patients with liver cirrhosis portal hypertension associated with hy- persplenism were treated with PSE, and color doppler ultrasound （CDU） was used to test blood flow mechanics indexes of hepatic artery, splenic artery, splenic vein, portal vein blood vessel diameter, average speed of blood flow, blood flow and arterial resistance. Statistical methods were used to analyze the observation of preoperative and postoperative index changes. Results After partial splenic artery embolization, compared with preoperative hepatic artery blood flow velocity, blood flow increased, splenic artery, splenic vein and portal vein blood vessel diameter and blood flow velocity and blood flow decreased to the preoperative period, P 〈 0.05. The difference was statistically significant. Conclusion Partial splenic embolization postoperative hepatic arterial blood flow increases, and splenic artery, splenic venous blood flow decreases, which can alleviate the spleen circulation state of high power and indirectly reduce portal vein pressure.