贲门周围血管离断术对门静脉血流动力学的影响

观察贲门周围血管离断术对门静脉血流动力学的影响,探讨手术与疗效的关系。方法:对22例门静脉高压病人行术前、后双功能多普勒超声检查和术中门静脉测压。结果:(1)术后门脉血流量(PVF)较术前减少18例,增加者4例。PVF的增减取决于胃冠状静脉侧支与脾静脉血流量的比值(CVF/SVF)。比值越小,术后PVF减少越显著;(2)术后肠系膜上静脉血流量增加;(3)门脉压力与PVF非同步变化,压力仍然维持较高水平。结论:上述血流动力学改变是临床上断流术后肝功能衰竭和脑病较少而远期再出血率较高的原因之一。

Effects of Pericardia Devascularization Procedure on Portal Hemodynamics

To observe the effects of portal hemodynamics after pericardia devascularization Me-thods: The hemodynamic studies were carried out by means of Duplex Doppler ultrasonography pre-and post-operatively, and the portal venous pressure was measured simultaneously. Results: (1) In most cases, the portal venous flow(PVF) decreased after pericardia devascularization. The changes of PVF depended mainly on the ratio of blood flow of collaterals in coronary gastric vein to that of the splenic vein(CVF/SVF); (2)The superior mesenteric venous flow was increased;(3)The free portal pressure was maintained at a high level. Conclusions: The hemodynamic changes observed could explain the rare occurrence of postoperative encephalopathy and frequent long term esophageal vericeal rebleeding.