介入性門脈斷流術(shù)對(duì)門靜脈血流動(dòng)力學(xué)的影響

趙春紅 季良

摘要：目的? 觀察介入性門脈斷流術(shù)對(duì)門靜脈血流動(dòng)力學(xué)指標(biāo)的影響。方法? 選取2018年1月～2019年1月在我院治療的60例乙肝肝硬化因食管胃底靜脈曲張出血合并脾功亢進(jìn)患者為研究對(duì)象，均采用胃冠狀靜脈栓塞加部分脾栓塞術(shù)治療，比較治療前后自由門靜脈壓（FPP）及門靜脈及脾靜脈介入術(shù)后6周門靜脈（PV）和脾靜脈（SV）的血流動(dòng)力學(xué)指標(biāo)（內(nèi)徑、平均血流速度、血流量）。結(jié)果? 胃冠狀靜脈栓塞術(shù)后FPP（42.61±5.02）cmH2O高于術(shù)前（37.01±4.22）cmH2O，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），聯(lián)合部分脾栓塞術(shù)后FPP（36.03±5.44）cmH2O下降，與胃冠狀靜脈栓塞術(shù)后比較，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），但與術(shù)前比較， 差異無統(tǒng)計(jì)學(xué)意義（P>0.05）;術(shù)后6周PV內(nèi)徑、平均血流速度、血流量與術(shù)前比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）;SV內(nèi)徑、平均血流速度、血流量均小于術(shù)前，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論? 胃冠狀靜脈栓塞術(shù)會(huì)引起門靜脈壓力升高，但聯(lián)合部分脾栓塞術(shù)后FPP會(huì)降低，且不影響門靜脈血流動(dòng)力學(xué)變化，對(duì)臨床合理選擇治療方式具有重要的指導(dǎo)意義。

關(guān)鍵詞：介入性;門脈斷流術(shù);門靜脈;血流動(dòng)力學(xué)指標(biāo)

中圖分類號(hào)：R575.2? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?文獻(xiàn)標(biāo)識(shí)碼：A? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?DOI：10.3969/j.issn.1006-1959.2020.08.033

文章編號(hào)：1006-1959（2020）08-0108-02

Abstract：Objective? To observe the influence of interventional portal vein devascularization on portal hemodynamics.Methods? 60 patients with hepatitis B cirrhosis due to esophagogastric varices bleeding and hypersplenism treated in our hospital from January 2018 to January 2019 were selected as the research subjects. All patients were treated with gastric coronary vein embolization plus partial splenic embolization. Before and after treatment， free portal vein pressure （FPP） and hemodynamic indicators （internal diameter， average blood flow velocity， blood flow） of portal vein （PV） and splenic vein （SV） 6 weeks after portal vein and splenic vein intervention.Results? The FPP （42.61±5.02） cmH2O after gastric coronary embolization was higher than that before （37.01±4.22） cmH2O， the difference was statistically significant （P<0.05）， and the FPP （36.03±5.44） cmH2O decreased after combined partial splenic embolization. Compared with postoperative gastric coronary embolism， the difference was statistically significant（P<0.05）， but compared with preoperatively， the difference was not statistically significant（P>0.05）; There was no statistically significant difference in PV inner diameter， average blood flow velocity and blood flow compared with preoperative 6 weeks after surgery（P>0.05）; SV inner diameter， average blood flow velocity and blood flow were less than before surgery， the difference was statistically significant（P<0.05）.Conclusion? Gastric coronary vein embolization can cause increased portal vein pressure， but FPP will decrease after combined partial splenic embolization， and it will not affect the hemodynamic changes of the portal vein. It has important guiding significance for the rational choice of clinical treatment.