门静脉血流动力学改变在食道胃底静脉出血中的作用

目的：研究门静脉高压症患者门静脉系统血流动力学改变与食管胃底静脉曲张破裂出血的关系。方法：83例门静脉高压症患者依照出血病史分为两组。A组（≤1次出血史）36例，B组（〉1次出血史）47例，行门静脉系统超声血流检查，术中门静脉测压。结果：A组患者门静脉直径、门静脉血流量、脾脏体积及流速方面显著高于B组；83例中54例（65．1％）有冠状静脉逆流。结论：门静脉系统高血流动力学是引起出血的基本条件，初期高血流动力学是机体代偿机制；多次出血史患者门静脉、脾静脉血流量明显下降；脾静脉主动充血在门静脉高压症的发生中起重要作用。著者文摘]

The role of portal venous haemodynamics in hemorrhage of esophagus and stomach

Objective To study the relationship between portal venous haemodynamics change and hemorrhage of esophagus and stomach. Methods 83 cases with portal venous hypertension were divided into group A (36 cases) with one time of upper gastrointestinal bleeding and group B (47 cases) with more than one time of upper gastrointestinal bleeding and examined by ultrasonic blood flowmeter. Results Group A has great difference with group B in portal venous diameter, portal venous blood flow, portal venous pressure and amount of hemorrhage 65.1% of cases had vena coronaria counter-flow. Conclusion Hyper-haemodynamics of portal system is the pacing factor of hemorrhage of esophagus and stomach and accounts for a compensation response at the initial stage. Initiative engorgement of spleen plays an important role in portal hypertension.