摘要
目的应用64排螺旋CT门静脉成像技术了解门静脉高压症患者的门静脉侧支循环状态,为临床选择合理手术方式提供参考。方法结合肝功能分级、门脉血流动力学及胃网膜血管压力等资料,并参考术前64排螺旋CT门静脉成像资料合理选择术式。结果经过64排螺旋CT门静脉成像检查发现,113例患者中,90例以胃冠状静脉、食管旁静脉、脾静脉曲张为主要表现;12例伴有脐静脉曲张、腹壁静脉曲张;6例伴有胃短静脉、胃后静脉曲张;4例伴有门静脉海绵样变或附壁血栓;1例伴有胃网膜血管广泛曲张。依据方法中手术选择标准,本研究113例患者中,选择行脾切除+贲门周围血管离断术的有51例;脾切除+选择性贲门周围血管离断术的有32例;脾切除+贲门周围血管离断术+中心性脾肾分流术的有25例;冠-腔静脉分流术的有2例;TIPS 3例。结论64排螺旋CT门静脉成像技术能很好地显示门静脉侧支循环状态,结合肝功能分级、门脉血流动力学及胃网膜血管压力等资料,能帮助术者选择门静脉高压症最为合理的手术方式。
Objective To investigate the state of collateral circulation of portal vein in patients with portal hypertension by 64-slice spiral CT portal vein imaging technology,so as to provide reference for clinical selection of reasonable operation methods.Methods Combined with the data of liver function classification,portal hemodynamics and gastroepiploic vascular pressure,and referring to the preoperative 64-slice spiral CT portal vein imaging data,the operation method was reasonably selected.Results In 113 cases of patients,64-slice spiral CT portal vein imaging revealed that 90 cases were mainly manifested by gastric coronary vein,paraesophageal vein and splenic vein varices;12 cases were accompanied by umbilical varices and abdominal varices;6 cases were accompanied by short gastric vein and posterior gastric varicose vein;4 cases were accompanied by cavernous transformation or mural thrombosis of portal vein;1 case was accompanied by extensive varicose of gastroepiploic vessels.According to the surgical selection criteria in the methods,among the 113 patients in this study,splenectomy+pericardial vascularization was selected in 51 cases;splenectomy+selective pericardial vascularization was selected in 32 cases;splenectomy+pericardiac vascularization+central splenorenal shunt was selected in 25 cases;coronal-vena cava shunt was selected in 2 cases;TIPS was selected in 3 cases.Conclusion The 64-slice spiral CT portal vein imaging technology can display the state of collateral circulation of portal vein very well.Combined with the data of liver function classification,portal hemodynamics and gastroepiploic vascularpressure,it can help the surgeon to select the most reasonable surgical method for portal hypertension.
作者
陈峰
赵磊
CHEN Feng;ZHAO Lei(Xi'an Civil Aviation Hospital,Xi'an 710082;Tangdu Hospital,Xi'an 710038,China)
出处
《临床医学研究与实践》
2021年第25期19-21,共3页
Clinical Research and Practice
关键词
门静脉高压症
门静脉侧支循环
64排螺旋CT门静脉成像
肝硬化
portal hypertension
collateral circulation of portal vein
64-slice spiral CT portal vein imaging
cirrhosis
