肝硬化合并脾功能亢进病人肝移植术后脾静脉血流动力学及外周血细胞变化的观察

目的 评价肝移植术中是否需保留脾脏。方法 应用彩色多普勒超声测量术前及术后第1、2及4周35例肝硬化合并脾亢病人脾脏的长径、厚径及脾门静脉管径、平均血流速度及峰值血流速度等并进行比较。同时期测量病人肝固有动脉管径及峰值血流速度、门静脉管径厦血流速度，检测病人外周血细胞计数。结果 术后病人脾脏缩小、脾门静脉平均血流速度及峰值血流速度、门静脉血流速度增加，外周血细胞计数上升，与术前相比有统计学差异（P〈0.05）。结论 肝移植术后脾功能亢进症状得到部分改善，这些症状的改善是否继续或有反复仍需进行长期的观察和研究。

Changes of blood flow dynamics of spleen vein and number of blood cells in circulation after liver transplant in patients with hepatocirrhosis and hypersplenism

Objective] To decide saving spleen or not in liver transplant, we compared changes of blood flow dynamics of spleen vein and number of blood cells in circulation before operation with that after operation. Method] In 35 patients with hepatocirrhosis and hypersplenism, we used color Doppler flow imaging to measure the length and thickness of spleen, width and blood flow velocity of spleen vein before liver transplant compare with that in 1st week, 2nd week and 4th week after operation. At the same time width and blood flow velocity of liver artery in port of liver, width and blood flow velocity of portae vein, the number of blood cells in circulation had been measured. Results] After liver transplant, the volume of spleen decreased, the mean blood flow velocity of spleen vein and the number of blood cells in circulation increased. Those changes were different significantly compared with that before operation (P <0.05). Conclusion] After liver transplant, the symptom of hypersplenism may be improved. But whether these good changes will go on or not still depend on long time observing and studying.