门静脉高压症不同术式对门静脉系统血流动力学的影响

目的 评价脾肾分流术(SRS)、贲门周围血管离断术(PCDV)及SRS PCDV术对门静脉系统血流动力学的影响. 方法 43例患者随机分为SRS组(11例)、PCDV组(20例)和SRS PCDV组(12例).手术前后运用彩色多普勒检测门静脉血流量(PVF)及术中动态测量自由门静脉压(FPP). 结果 分流组术后PVF及FPP与术前差异有显著性(P＜0.01).断流组术后PVF减少,差异无显著性意义(P＞0.05),FPP降低有显著性(P＜0.05).SRS PCDV组术后PVF减少和FPP降低差异有显著性(P＜0.05).3组间PVF和FPP差异有显著性(P＜0.05). 结论 分流 断流联合术(SRS PCDV)即能有效地降低门静脉压力,又能维持门静脉血流向肝灌注,是治疗门静脉高压症合理的术式.

Effects of Various Surgical Procedures on Portal Hemodynamice in Patients with Potal Hypertension

Objective To evaluate the effects of splenorenal vein shunt(SRS), peripheral cardiac divided vessel(PCDV)and SRS+PCDV on hemodynamics of portal venous system.Methods Forty-three patients were randomly divided into three groups: SRS group (11 cases), PCDV group (20 cases),and SRS+PCDV group (12 cases). The portal venous flow (PVF) and free portal pressure(FPP)were measured by Doppler color ultrasound before and after operation, during operation.Results In SRS group the postoperative compared to preopative PVF and FPP decreased (P<0.01). In PCDV group PVF decreased(P>0.05), there was not significant difference Fpp decreased (P<0.05). In SRS+PCDV group PVF and FPP decreased by respectively(P<0.05). PVF and FPP among groups were statistically significant (P<0.05).Conclusion SRS+PCDV procedure decreased the portal hypertension meanwhile, it also maintains liver perfusion. It is reasonable in the treatment of portal hypertension.