3.0 T MRV辅助DSA介入治疗布加综合征患者效果临床研究

目的 研究3.0 T 磁共振静脉成像(MRV)辅助数字减影血管造影(DSA)下治疗布加综合征(BCS)患者的临床疗效。方法 2014年3月～2019年3月我院收治的120例BCS患者,接受3.0 T MRV检查,并在此成像指导下行DSA下介入治疗。结果 MRV检查下腔静脉闭塞端危险交通支和闭塞端形态显示率分别为7.5%和25.0%,显著低于DSA检查的40.0%和60.0%(P＜0.05),对肝静脉各支(右、中、左)和副肝静脉显示率分别为95.0%、80.0%、75.0%和52.5%,显著高于DSA检查的40.0%、35.0%、30.0%和17.5%(P＜0.05),对下腔静脉节段狭窄、下腔静脉闭塞、下腔静脉膜性带孔和血栓显示率与DSA造影比较差异均无统计学意义(P＞0.05);120例患者经介入治疗均获得成功,其中21例(17.5%)经股静脉入路,63例(52.5%)经右股静脉和右颈内静脉双向入路,3例(2.5%)经皮肝穿刺肝静脉联合颈内静脉双入路,33例(27.5%)经右颈内静脉入路。结论 采用3.0 T MRV检查能清晰地显示BCS患者血管阻塞情况,弥补DSA造影的不足,对介入诊疗有很大的辅助作用。     

分段注射对比剂CT增强扫描提高乙型肝炎肝硬化患者肝静脉显影效果研究*

目的 研究分段注射对比剂CT造影对乙型肝炎肝硬化患者肝静脉显影效果的影响。方法 2018年3月～2020年9月我院诊治的乙型肝炎肝硬化患者62例,在CT增加造影检查时,分为观察组32例,采取分段注射对比剂,和对照组30例,常规注射对比剂碘伏醇。记录肝动脉灌注量(HAP)、门静脉灌注量(HPP)、肝动脉灌注指数(HPI)和动脉灌注分数(APF)。结果 在32例观察组中,CTA显影图像质量显著优于对照组(P<0.05);观察组与对照组肝静脉CT值【(138.6±13.4)HU 对(125.5±11.8)HU】、门静脉主干CT值【(218.8±41.3)HU对(176.9±35.8)HU】、门静脉右支CT值【(204.6±31.5)HU对(163.3±28.7)HU】和门静脉左支CT值【(198.5±21.9)HU 对(154.0±23.2)HU】比较,差异均有统计学意义(P<0.05);观察组与对照组对比剂门静脉峰值时间【(17.5±2.2)HU 对(19.7±3.0)HU】和肝实质峰值时间【(35.7±3.8)HU对(40.1±4.3)HU】比较,差异均有统计学意义(P<0.05);两组HAP【(16.3±4.8)ml/min/100ml 对 (15.8±5.2)ml/min/100ml】、HPP【(18.9±5.7)ml/min/100ml对(17.5±6.4)ml/min/100ml】、HPI【(40.6±10.1)% 对(42.2±9.6)%】和APF【(31.2±8.3)%对(30.9±7.5)%】比较,差异均无统计学意义(P>0.05)。结论 采取分段注射对比剂行CTA造影检查有助于提高乙型肝炎肝硬化患者腹部CT检查的图像质量,尤其是能提高肝静脉显影效果,有助于指导临床诊治。     

肝血管瘤、肝细胞癌和肝血管平滑肌脂肪瘤超声造影特点观察*

目的 探讨肝血管瘤(HCH)、肝细胞癌(HCC)和肝血管平滑肌脂肪瘤(HAML)患者肝内病灶超声造影特点。方法 2017年11月～2020年11月我院诊治的肝占位病变患者112例,所有患者入院后均在治疗前接受常规超声和超声造影检查,观察肝内病灶数目、大小、边界、回声、形态、血供等信息,同时观察超声造影检查过程中动脉期、门静脉期和延迟期病灶的增强模式。结果 经组织病理学检查诊断为HCH患者39例,HCC患者64例和HMAL患者9例;HCH患者女性占比为66.7%,显著高于HCC或HAML患者(分别为18.8%和33.3%,P＜0.05),HCC患者年龄为(57.5±5.8)岁,HMAL患者年龄为(55.3±5.1)岁,均显著大于HCH患者【(46.2±5.2)岁,P<0.05】,HCC患者存在HBV感染发生率为76.6%,显著高于HMAL患者的28.6%或HCH患者的12.8%(P<0.05);在普通超声检查,HCC病灶边界不清、实质呈低回声和混合回声占比分别为65.6%、43.8%和42.2%,显著高于HCH病灶的2.6%、10.3%和7.7%或HAML病灶的0.0%、11.1%和11.1%(P＜0.05),HCH、HCC和HAML患者肝内病灶数目、病灶大小、形态和血供比较,差异无统计学意义(P＞0.05);在超声造影检查方面,HCH病灶在动脉期呈高增强占比为92.3%,显著高于HCC病灶的87.5%或HMAL病灶的88.9%(P＜0.05),HCC病灶门静脉期和延迟期呈低增强占比分别为65.6%和90.6%,显著高于HCH病灶的5.1%和43.6%或HMAL病灶的11.1%和22.2%(P＜0.05)。结论 HAML、HCH和HCC病灶在超声检查方面各具特点,而超声造影检查更具诊断和鉴别诊断价值,值得进一步研究。     

肝动脉变异在活体肝移植中的处理

目的:探讨活体肝移植术前肝动脉评估、术中切取及吻合方式和术后处理方法.方法:回顾性分析活体肝移植患者2例的肝动脉处理方法,通过术前CT血管造影术(CTA)评估供受体肝动脉走形,拟定术中肝动脉的切取方式及吻合方法,探讨移植术后预防肝动脉并发症的方法.结果:CTA是术前评估供受体血管简单有效的方法.肝动脉有变异或动脉内径非常细的情况下,将受体一段动脉完整游离切除在后台和供体肝动脉在高倍显微镜下吻合,可提高动脉吻合质量.术后超声检查的精确性受上腹部气体影响明显时,CTA检查可明确吻合肝动脉的流通状况.术后应及早使用抗凝治疗,及时准确调整全身凝血功能,防止肝动脉栓塞.结论:术前正确的评估和高质量的动脉吻合以及术后适当抗凝治疗是预防术后肝动脉并发症的有效措施.     

实时超声弹性成像技术对原位肝移植患者术后缺血型胆道病变临床评估价值分析*

目的 探讨应用实时超声弹性成像技术对原位肝移植术后缺血型胆道病变的临床评估价值。方法 2013年1月~2017年1月在我院接受肝移植患者52例,使用彩色多普勒超声和实时超声弹性成像技术检测门静脉最大截面直径（PVD）、肝动脉阻力指数（HARI）、门静脉流速（PVV）、肝动脉搏动指数（HAPI）、肝动脉收缩期峰值流速（HAV）,并测量剪切波速度（SWV）。结果 术后6个月复查,胆道病变患者超声检查主要表现为与门静脉左右支伴行的肝内胆管呈管状等回声,彩色多普勒血流成像显示胆管低回声旁门静脉血流信号明显变细;在52例患者中发现缺血型胆道病变10例（19.2%）;胆道病变与无胆道病变患者PVV、HAV、HARI和HAPI比较,差异无统计学意义（P>0.05）,胆道病变患者PVD显著高于无胆道病变者【（1.1±0.2） cm/s对（0.8±0.3） cm/s,P<0.05】;两组血清AST水平差异无统计学意义（P>0.05）,但胆道病变患者血清ALP和GGT水平显著高于无胆道病变者（P<0.05）;在检测深度分别为4 m和5 cm时,胆道病变患者SWV显著高于对照组,差异均有统计学意义（P<0.05）。结论 实时超声弹性成像技术在原位肝移植术后缺血型胆道病变的临床评估方面具有经济、方便、无创、易重复的特点,对病变的监测具有重要的临床意义。     

肝脓肿患者超声造影特点及诊断价值分析

目的 研究肝脓肿患者超声造影(CEUS)检查表现特点及诊断价值。方法 2016年4月～2019年4月我院收治的120例肝脓肿患者,行常规二维超声和CEUS检查,分析其影像学特征,以穿刺治疗结果为金标准,分析CEUS和常规二维超声诊断肝脓肿病灶的一致性。结果 在120例患者中,脓肿炎性期22例,脓肿形成初期42例和脓肿形成期56例;常规二维超声检出107例(89.2%),其中脓肿炎性期和脓肿形成初期影像学表现为不规则或规则病灶,病灶边界不清晰或清晰,病灶内未见液性暗区,可见血流信号,脓肿形成期影像学表现为不规则或规则病灶,病灶边界不清晰或清晰,病灶内见液性暗区,无血流信号;CEUS检出肝脓肿117例(95.0%),其中脓肿炎性期和脓肿形成初期影像学表现为病灶动脉期高增强,门静脉期和延迟期低增强,显示范围较常规超声明显增大,脓肿形成期影像学表现为病灶动脉期高增强,门静脉期和延迟期低增强现象减少,显示范围较常规超声明显增大;CEUS诊断肝脓肿病灶的灵敏度为95.0%,特异度为76.9%,阳性预测值为89.7%,阴性预测值为33.3%,Kappa值为0.88。结论 不同病程的肝脓肿CEUS影像学表现各有特点,其诊断肝脓肿的灵敏度、特异度和准确性均较高,在鉴别诊断有困难时可以考虑应用。     

脾切除术与TIPS术治疗肝硬化患者门静脉血栓发生率比较*

目的 比较脾切除术与经颈静脉肝内门腔静脉内支架分流术(TIPS)治疗肝硬化患者门静脉血栓(PVT)发生率的差异。方法 2017年1月～2018年12月兰州大学第一医院诊治的肝硬化并发脾功能亢进症患者96例,其中接受脾切除者45例,接受TIPS术治疗者51例。术后随访12个月,使用腹部超声或CT或CTA检查诊断PVT。应用Kaplan-Meier法计算PVT累计发生率。结果 在术后1个月、3个月、6个月和12个月,脾切除术组PVT累计发生率分别为40.0%、46.7%、48.9%和48.9%,显著高于TIPS术组(分别为7.8%、9.8%、15.7%和21.6%,P<0.05);在接受脾切除术患者,基线指标比较发现PVT组门静脉主干直径显著大于非PVT组,差异具有统计学意义(P<0.05);在TIPS术后1年,发生PVT患者11例(21.6%)。基线指标比较,未发现发生与未发生PVT组各指标具有统计学差异(P>0.05)。结论 在肝硬化并发脾功能亢进症患者,接受脾切除术后PVT累计发生率显著高于TIPS术。因此,术前应认真评估病情,严格掌握适应证,择优选择手术方法,并积极给予防治处理。     

DCE-MRI诊断原发性肝癌效能和TACE术后评估肿瘤活性应用价值研究*

目的 探讨动态对比增强磁共振成像(DCE-MRI)检查诊断原发性肝癌(PLC)患者的效能及评价疗效的价值。方法 2017年1月～2021年6月我院诊治的肝占位性病变患者68例,均接受DCE-MRI检查,并行穿刺细胞学检查诊断,应用临床流行病学基本技术评估MRI诊断的效能。所有PLC患者接受经皮肝动脉化疗栓塞术(TACE)治疗,术后再次接受MRI检查,评估疗效。结果 DCE-MRI检查显示PLC患者肝内特征性恶性肿瘤表现,T1WI序列为低信号,T2WI序列为高信号,动脉期明显强化,门脉期快速消退,偶见明显的肿瘤包膜;在68例肝占位性病变患者,经穿刺细胞学检查,诊断PLC患者64例,非肿瘤病变4例;DCE-MRI检查诊断的灵敏度、特异度、准确率、阳性和阴性预测值分别为95.2%、75.0%、89.7%、93.8%和25.0%;在TACE术后,MRI检查发现肿瘤被完全灭活18例(28.1%),部分灭活25例(39.1%),肿瘤稳定15例(23.4%),疾病进展6例(9.3%)。结论 DCE-MRI检查在诊断PLC和治疗后疗效判断方面有独特的作用,可指导临床制定治疗方案,价值很大。     

肝移植术后缺血型胆道病变发生危险因素分析

目的 探讨肝移植术后缺血型胆道病变(ITBL)发生的危险因素。方法 2015年1月～2019年2月我院收治的接受肝移植术治疗患者312例,根据肝功能、胆道造影和影像学检查结果诊断术后ITBL的发生,采用单因素和多因素Logistic 回归分析。结果 本组312例接受肝移植术患者原发疾病以原发性肝癌为主(占45.8%),术后发生ITBL者37例(11.9%);经Logistic回归分析显示输入血浆的量(OR=1.2,P=0.01)、术后1周肝动脉阻力指数(RI,OR=8.9,P=0.03)、急性排斥反应(OR=7.0,P=0.02)、冷缺血时间≥11.5 h(OR=1.1,P=0.01)为影响患者发生ITBL的独立影响因素。结论 肝移植术后患者易发生ITBL,需针对诱发因素给予针对性的预防处理,以提高肝移植效果。     

肝动脉变异的解剖学及比较影像学研究现状

肝动脉变异对于肝癌化疗药栓塞治疗、肝脏部分外科切除、全肝或部分肝移植和肝脏疾病的诊疗等有重要意义。为提高诊疗水平,避免诊治中严重并发症的发生,全面了解肝动脉解剖变异非常必要。除数字减影血管成像(DSA)外,CT血管成像(CTA)、核磁共振血管成像(MRA)、彩色多普勒超声(CDF)新技术的应用又开辟了肝动脉变异认识的新方法。本文就肝动脉变异的解剖学及比较影像学研究现状做一综述。     

重组人血管内皮抑制素联合肝动脉介入治疗对中晚期肝癌无疾病进展生存期的影响

目的观察重组人血管内皮抑制素(恩度)联合肝动脉介入治疗对中晚期肝癌无疾病进展生存期的影响。方法选取2011年3月-2015年5月福建省肿瘤医院收治的86例中晚期肝癌患者,按照配对设计分为治疗组和对照组。治疗组(n=43)采用恩度联合肝动脉介入治疗;对照组(n=43)采用肝动脉介入治疗联合口服中药肝复乐。计数资料组间比较采用χ2检验,计量资料组间比较采用t检验。Kaplan-Meier法进行生存分析,单因素分析采用Log-rank法,多因素回归分析采用Cox比例风险模型。结果治疗组和对照组的中位无疾病进展生存期分别为154 d[95%可信区间(95%CI):94~214 d]、70 d(95%CI:39~101 d),两组比较差异具有统计学意义(χ2=10.741,P=0.001)。单因素分析显示,肝硬化严重程度、肿瘤个数、门静脉主干癌栓/下腔静脉癌栓是中晚期肝癌患者预后的影响因素(χ2值分别为8.182、9.150、6.565,P值分别为0.004、0.027、0.038);多因素分析显示,肝硬化严重程度、门静脉主干癌栓/下腔静脉癌栓是恩度联合肝动脉介入治疗影响中晚期肝癌无疾病进展生存期的独立预后因素(P值分别为0.028、0.013)。结论恩度可延长中晚期肝癌介入治疗后的无疾病进展生存期,但对严重肝硬化、门静脉主干癌栓/下腔静脉癌栓患者优势不明显。     

MRI LAVA扫描技术评估布-加综合征患者侧支循环研究

目的 分析采用磁共振成像(MRI)肝脏加速容积采集(LAVA)扫描技术评估布-加综合征(BCS)患者侧支循环的效果。方法 2017年3月～2022年3月我院收治的BCS患者47例,均接受数字减影血管造影(DSA)和MRI检查。以DSA检查结果为“金标准”,判断MRI LAVA对BCS分型诊断的准确率。结果 DSA检查诊断肝静脉阻塞型BCS 18例,下腔静脉阻塞型BCS 21例和混合型BCS 8例,而MRI LAVA诊断肝静脉阻塞型16例,下腔静脉阻塞型21例,混合型10例,其准确性为95.7%;在47例BCS患者中,MRI LAVA显示膈下静脉扩张9例(19.1%),肝内交通支扩张12例(25.5%),腹壁浅静脉扩张26例(55.3%),副肝静脉扩张26例(55.3%),奇/半奇静脉扩张39例(83.0%);与DSA检查比,MRI LAVA显示副肝静脉的准确性为100%。结论 采用MRI LAVA扫描技术能够准确判断BCS分型,观察不同类型侧支循环建立情况,为临床诊疗提供依据。     

Relationship between encephalopathy and portal vein-vena cava shunt： Value of computed tomography during arterial portography

AIM: TO assess the value of computed tomography during arterial portography (CTAP) in portal vein-vena cava shunt,and analysis of the episode risk in encephalopathy.METHODS: Twenty-nine patients with portal-systemic encephalopathy due to portal hypertension were classified by West Haven method into grade Ⅰ(29 cases), gradeⅡ(16 cases), grade Ⅲ(10 cases), grade Ⅳ( 4 cases). All the patients were scanned by spiraI-CT. Plane scans, artery phase and portal vein phase enhancement scans were performed, and the source images were thinly reconstructed to 1.25 mm. We reconstructed the celiac trunk, portal vein,inferior vena cava and their branches and subjected them to three-dimensional vessel analysis by volume rendering(VR) technique and multiplanar volume reconstruction (MPVR) technique. The blood vessel reconstruction technique was used to evaluate the scope and extent of portal vein-vena cava shunt, portal vein emboli and the fistula of hepatic artery- portal vein. The relationship between the episode risk of portal-systemic encephalopathy and the scope and extent of portal vein-vena cava shunt,portal vein emboli and fistula of hepatic artery- portal vein was studied.RESULTS: The three-dimensional vessel reconstruction technique of spiraI-CT could display celiac trunk, portal vein,inferior vena cava and their branches at any planes and angles and the scope and extent of portal vein-vena cavashunt, portal vein emboli and the fistula of hepatic artery- portal vein. In twenty-nine patients with portal-systemicencephalopathy, grade Ⅰ accounted for 89.7% esophageal varices, 86.2% paragastric varices; grade Ⅱ accounted for 68.75% cirsomphalos, 56.25% paraesophageal varices,62.5% retroperitoneal varices and 81.25% dilated azygos vein; grade Ⅲ accounted for 80% cirsomphalos, 60%paraesophageal varices, 70% retroperitoneal varices, 90% dilated azygos vein, and part of the patients in grades Ⅱand Ⅲ had portal vein emboli and fistula of hepatic arteryportal vein; grade Ⅳ accounted for 75% dilated left renal vein, 50% paragallbladder varices, all the patients had fistula of hepatic artery- portal vein.CONCLUSION: The three-dimensional vessel reconstruction technique of spiraI-CT can clearly display celiac trunk, portal vein, inferior vena cava and their branches at any planes and angles and the scope and extent of portal vein-vena cava shunt. The technique is valuable for evaluating the episode risk in portal-systemic encephalopathy.     

Stent implantation for iliac compression syndrome with acute deep vein thrombosis: a case report

An 80-year-old woman presented with left lower limb pain and swelling with tenderness over the great saphenous vein. Venography revealed thrombus in the lower leg vein and occlusion of the femoral vein. A temporary vein filter was placed below the renal vein and catheter intervention was performed. The wire was carefully advanced from the left femoral vein to the vena cava. Hard resistance was felt at the proximal iliac vein. After balloon dilation, intravascular ultrasonography showed a very flat lumen at the occlusion site. Stent implantation was performed followed by anticoagulation therapy. Venography at 3 months follow-up showed a widely opened iliac vein. Angiography showed the occlusion site was the crossing point of the right iliac artery and left iliac vein. Stenting for iliac compression syndrome is effective to maintain patency of the vein.     

Circadian variation of portal, arterial and venous blood levels of melatonin in pigs and its relationship to food intake and sleep

Circadian levels of melatonin were determined in the hepatic portal vein, cranial vena cava, and the lower aorta of ten juvenile pigs. Blood was sampled every hour for a total of 24 hr via temporary cannulas introduced into blood vessels under anesthesia. No peak levels of melatonin were found in the mid-scotophase, but hepatic portal concentrations peaked at 06.00 hr. Overall levels of melatonin were highest in the hepatic portal vein (range 35–65 pg/mL), followed by an artery (range 30–55 pg/mL) and the vena cava (range 25–35 pg/mL). Levels of melatonin exhibit strong variation between individual pigs, but generally the average levels from all three sources follow each other's time course. However, on occasion, melatonin levels in the hepatic portal vein varied independently from the levels in the vena cava. Large portal peaks were usually preceded by a feeding period and were associated with a subsequent period of sleep. The data indicate that: 1) there is no clear circadian rhythm of melatonin in the peripheral blood of pigs, 2) relatively little melatonin is metabolized during the first liver passage, 3) food intake may elevate melatonin levels in the hepatic portal vein, and 4) increased levels of melatonin originated in the gastrointestinal tract may induce sleep.     

Congenital absence of the portal vein complicating hepatic tumors

Congenital absence of the portal vein (CAPV) is a rare malformation that is often accompanied by other anomalies such as cardiac and skeletal malformations and/or hepatic tumors. We describe here a case of CAPV complicating hepatic tumors in a 16-year-old Japanese girl. Abdominal ultrasonography revealed a hyperechoic tumor in the liver and dilatation of the portal vein that appeared to be connected directly with the inferior vena cava. Subsequent abdominal computed tomography (CT) revealed tumors and magnetic resonance angiography confirmed that the portal vein entered directly into the inferior vena cava just above the liver. In addition, there was absence of the right portal vein and the left intrahepatic branch except for the presence of left portal vein only within the porta hepatis. These findings led to a diagnosis of CAPV complicated hepatic tumors. Careful monitoring of these hepatic tumors is ongoing due to the possibility of malignant transformation.     

CT血管三维重建鉴别布加综合征与乙型肝炎肝硬化价值分析*

目的 研究CT血管三维重建对鉴别布加综合征(BCS)与乙型肝炎肝硬化的临床价值。方法 2017年3月～2020年3月我院诊治的BCS患者28例,乙型肝炎肝硬化患者46例,接受CT血管三维重建检查,记录两组CT三维重建检查影像学特点。采用Logistic多因素回归分析探讨各征象对诊断BCS的价值,并建立回归方程。采用受试者工作特征曲线(ROC)分析回归方程诊断BCS的应用价值。结果 BCS组肝内静脉侧支开放发生率为82.1%,显著高于肝硬化组的15.2%(P<0.05),奇静脉与腰升静脉交通发生率为46.4%,显著高于肝硬化组的10.9%(P<0.05),下腔静脉和肝静脉充盈缺损为85.7%和92.9%,显著高于肝硬化组的10.9%和8.7%(P<0.05);腹膜后静脉丛曲张为35.7%,显著高于肝硬化组的10.9%(P<0.05),尾状叶增大为64.3%,显著高于肝硬化组的6.5%(P<0.05),地图状/雪花样强化为82.1%,显著高于肝硬化组的6.5%(P<0.05),门脉期不均匀强化为85.7%,显著高于肝硬化组的13.0%(P<0.05);Logistic多因素分析显示肝内静脉侧支开放(95%CI=1.035～3.332,P=0.038)、奇静脉与腰升静脉交通(95%CI=1.203～2.296,P=0.002)、下腔静脉充盈缺损(95%CI=1.694～4.893,P=0.000)、肝静脉充盈缺损(95%CI=1.695～3.156,P=0.000)、尾状叶增大(95%CI=1.012～1.901,P=0.042)和门脉期不均匀强化(95%CI=1.234～2.916,P=0.004)是诊断BCS的独立指标;ROC分析结果显示我们建立的回归方程诊断BCS的AUC为0.888(95%CI=0.812～0.965,P=0.000),显著高于其他各征象诊断。结论 CT血管三维重建检查有助于鉴别BCS与乙型肝炎肝硬化,综合CT三维重建征象建立预测模型有助于对BCS患者的早期筛查和诊断。     

Role of hepatic artery in haemodynamics in normal and cirrhotic livers in rats

To examine the degree of influence of the hepatic artery on microcirculation in the liver, microscopic observation of blood flow in the hepatic minute blood vessels and the sinusoids and pressure measurements at key points in hepatic vascular pathways in vivo were performed before and after hepatic artery ligation in normal and cirrhotic rats. In normal rats, portal vein pressure (109 mmH2O) fell 10 mmH2O after hepatic artery ligation, but the pressures of the terminal portal venule, the terminal hepatic venule and the inferior vena cava did not change. In cirrhotic rats, portal vein pressure (206 mmH2O) and terminal portal venule pressure (106 mmH2O) fell 23 and 10 mmH2O after hepatic artery ligation respectively: the pressures in the terminal hepatic venule and the inferior vena cava did not change. These results suggests that the pressure transmitted from the hepatic artery was mostly supplied to the intrahepatic portal vein in normal rats and both to the intrahepatic portal vein and to the sinusoids in cirrhotic rats. In both normal and cirrhotic rats, however, the pressure transmitted from the hepatic artery was about 10 per cent of the initial portal vein pressure, and the blood flow in minute vessels and sinusoids did not change after hepatic artery ligation. Accordingly, it is believed that the hepatic artery plays only a small role in the haemodynamics of the liver in both normal and cirrhotic rats, irrespective of the distribution and manner of the hepatic arterial termination.     

急性重症酒精性肝炎肝动脉缓冲效应研究进展*

目的 急性重症酒精性肝炎患者肝窦存在致密胶原沉积,阻力增加阻碍了血液流经肝窦,窦性压力增加,门静脉血流不畅,门静脉向肝窦的灌注显著减少,此时就启动了肝动脉缓冲效应,后者可以抵消肝脏灌注的两个主要血管肝动脉或门静脉中任何一个的流量减少,维持肝脏总血流量在一个生理范围内,使肝脏灌注(肝动脉和门静脉血流之和)恢复正常。双功能多普勒超声可以无创评估肝脏血流动力学和定量肝动脉缓冲效应。因此,肝动脉缓冲效应可能成为诊断急性重症酒精性肝炎的重要检测方法之一。