摘要
目的 :测定分流 (SRS)加断流手术 (PCDV)前后门静脉系统血流动力学变化 ,评价其在门静脉高压症外科治疗中的价值。方法 :应用彩色多普勒检测 99例门静脉高压症病人手术前后对门静脉系统的血流动力学的影响 ,术中动态测量门静脉压力。结果 :①SRS +PCDV组 :术后PVF减少 36 .1 0 %± 7.8% ,FPP下降 33 .99%± 9.53 %。FPP的下降与PVF的减少呈正相关 ,PVF和FPP较术前下降 (P <0 .0 5) ,但维持在正常高限且保持门静脉向肝血流 ;②SRS +PCDV组术后的PVF和FPP均介于断流组与脾肾分流组之间 ,且各组之间有显著差异 (P <0 .0 5)。结论 :分流手术后门静脉血流向肝内高灌注 ,门静脉系统瘀血状态依然存在。分流术后门静脉高压瘀血状态缓解 ;门静脉血流肝内灌注显著减少。分流术后门静脉压力降低 ,加做断流术后门静脉压力有不同程度回升 ,术后的PVF和FPP均介于断流术和分流术之间 ,该术式明显优于单纯分流术或断流术。
To study the clinical and hemodynamic changes of the portal venous system after spleno renal shunt plus pericardial devascularization(SRS+PCDV). Methods: In 99 patients with portal hypertension(PH), the hemodynamic parameters of the changes of the portal venous system were studied by Doppler color flow imaging(DCFI) before, during and after operation. Results: SRS+PCDV group: The PVF and FPP respectively decreased by 36.1%±7.8% and 33.99%±9.53% postoperatively comparing with preoperation(P<0.05), which still corresponded to the normal upper limit, suggesting that the liver kept a good perfusion from the portal vein. The postoperative pressure of PVF and FPP in SRS+PCDV group were higher than that of SRS group(P<0.05), but lower than that of PCDV group(P<0.05). Conclusions: ①After PCDV, the hepatic perfusion from the portal vein was still kept within normal limits. ②The congestive state of the portal vein was released after SRS, hepatic perfusion from the portal vein was thus decreased significantly. ③SRS+PCDV could decrease moderately the PVF and FPP, and helped to stop the bleeding. The hepatic perfusion was in a good state after SRS+PCDV, while the congestive state of the portal venous system was released as well.
出处
《外科理论与实践》
2002年第4期276-279,共4页
Journal of Surgery Concepts & Practice
