摘要
目的探讨胆总管囊肿肝脏血液动力学变化的意义。方法彩色多普勒血流显像（ＣＤＦＩ）监测２２例胆总管囊肿患儿手术前后肝脏血液动力学变化，并取肝活检观察组织学及血管形态学改变。结果肝病变主要在汇管区，炎性细胞浸润、小胆管及纤维组织增生，门脉分支受压而小动脉数目增多，据此将肝病变分为Ⅰ、Ⅱ和血型；门脉截面积手术前后无明显变化（Ｐ＞０．０５），肝动脉术前较术后扩张（Ｐ＜０．０１）。ＣＤＦＩ监测门脉流速、血流量和肝动脉阻力指数Ⅰ型肝病变手术前后无改变；Ⅱ、Ⅲ型术前明显降低（Ｐ＜０．０１），术后Ⅱ型基本恢复正常，Ⅲ型有所增加。结论肝脏血流参数随其病变程度加重而下降；肝脏病损主要系胆道梗阻所致，在一定程度上可逆；ＣＤＦＩ可用于判断肝脏病损情况。
Objective To correlate the hepatic hemodynamic change in Patients with choldchalcysts. Methods Pre and pet-operative hepatic hemodyndric studies were performed on 22 children withcholdchal cysts'using colour boler flow wing (CDFI). Morphometric study of the specimen was performed with computerised medical image analysis system (CMIAS). Results Pathological change occurredmainly around the porta hepatis with infiltration of inflammatory cells, proliferation of cholangioles and fi-brosis. Arterioles proliferated and venulae were compressed with the advanced disease. The Pathology wascategorised into group I, II and III according to the Seventy of damage. While the crooss-scetional area ofportal vein did not change mp-operatively (P >0. 05 ), the internal diameter of the hepatic artery increasedsignificantly (P > 0. 01 ). The pre-operative portal venous velocity (PVV), portal venous blood flow(PVF) and hepatic arterial resistance index (HARI) were normal in group I but decreased in grou II andIII. Post-operatively, these parameters returned to normal in group if but increased significantly in groupIII Conclusions The hemodynamic parameters deteriorated with the seventy of liver impairment. Thechanges were secondary to binary obstruction. The damage to liver is reversible to certain extent. Doppler is effective in monitoring these changes.
出处
《中华小儿外科杂志》
CSCD
1999年第3期140-142,共3页
Chinese Journal of Pediatric Surgery
