慢性重型肝炎门静脉系统血流动力学变化的研究

目的探讨慢性重型病毒性肝炎门静脉系统血流动力学变化.材料和方法应用多普勒超声检测30例慢性重型肝炎患者门静脉系统血流动力学变化,并与正常组(51例)、慢性肝炎组(61例)、代偿期肝硬化组(46例)、失代偿期肝硬化组(36例)进行对照研究.结果慢性重型肝炎门静脉直径稍宽于正常组,而明显低于失代偿期肝硬化,与慢性肝炎组及代偿期肝硬化无差异;门静脉血流速度、血流量显著低于对照各组;脾脏长径、脾静脉直径较正常组和慢性肝炎组增大、增宽,但明显小于失代偿期肝硬化,与代偿期肝硬化无差异;脾静脉血流量与各组比较均没有明显增加;脐静脉重开率显著高于慢性肝炎组及代偿期肝硬化组,与失代偿期肝硬化组无差异.结论慢性重型肝炎容易形成门静脉高压,门静脉血流灌注量明显减少,造成肝脏微循环障碍.

Study on Hemodynamic Changes of Portal Vein System in Chronic Hepatitis Gravis

Purpose: To study the portal vein hemodynamic changes in chronic hepatitis gravis. Materials and Methods: The hemodynamics of portal vein system was assessed by Doppler ultrasound in 30 cases of chronic hepatitis gravis,51 normal, 61 chronic hepatitis, 46 compensated, and 36 decompensated cirrhosis. Results: In chronic hepatitis gravis portal vein diameter was larger than normal, but smaller than decompensated cirrhosis. No obvious difference was found between chronic hepatitis and compensated cirrhosis. The velocity and flow signal in portal vein were obviously low. The similar trend on splenic size and vein diameter was also noticed, but no obviously increased splenic venous blood flow. Umbilical vein re opening was more frequently noted than compensated cirrhosis and chronic hepatitis. Conclusion: Chronic hepatitis gravis is apt to form acute portal hypertension with decreased perfusion of portal vein system thus causing liver in a state of lacking of blood and oxygen.