摘要
目的分析脾切除贲门周围血管离断术后患者门静脉和肝动脉血流动力学变化特征。方法选取2014年6月至2017年6月首都医科大学附属北京佑安医院因门静脉高压症行脾切除贲门周围血管离断术的患者132例,记录患者术前和术后1个月、3个月、6个月、12个月、24个月、36个月的门静脉、肝动脉血流动力学变化数据和肝弹性值,分析患者术前和术后各时间点肝血流的变化特征。结果132例患者中男89例、女43例,年龄27~74岁,平均(48.6±10.6)岁。与术前相比,术后1个月、3个月、6个月、12个月、24个月、36个月患者的肝硬度均较低,且术后1个月、3个月、6个月、12个月、24个月的门静脉流量、流速均较低,差异均有统计学意义(P<0.05)。与术前相比,术后1个月患者的肝动脉流量较高,差异有统计学意义(P<0.05)。结论脾切除贲门周围血管离断术后患者短期和长期的肝硬度、门静脉流量、平均流速均较术前显著降低,脾切除贲门周围血管离断术可能在一定程度上逆转患者肝硬化,并改善肝功能。
Objective To analyze the hemodynamic changes of portal vein and hepatic artery after splenectomy and pericardial devascularization.Methods A total of 132 patients with portal hypertension who underwent splenectomy and pericardial devascularization in Beijing You'an Hospital from June 2014 to June 2017 were selected.The hemodynamic changes of portal vein and hepatic artery and hepatic elasticity were recorded before and 1 month,3 months,6 months,12 months,24 months and 36 months after operation,and the characteristics of hepatic blood flow before and after operation were analyzed.Results Among the 132 patients,there were 89 males and 43 females,aged from 27 to 74 years,with an average of(48.6±10.6)years.Compared with before operation,the liver hardness of patients at 1 month,3 months,6 months,12 months,24 months and 36 months after operation were significantly lower,and the portal vein flow and velocity at 1 month,3 months,6 months,12 months and 24 months after operation were lower,with statistical significance(P<0.05).Liver hardness was positively correlated with portal vein flow and flow range.Compared with before operation,the hepatic artery flow rate of patients one month after operation was higher,and the difference was statistically significant(P<0.05).Conclusions After splenectomy and pericardial devascularization,the short-term and long-term liver hardness,portal vein flow and average velocity are significantly lower than those before operation,and the liver hardness is positively correlated with portal vein flow and average velocity range.Splenectomy and pericardial devascularization may reverse liver cirrhosis to some extent and improve liver function.
作者
赵晓飞
朱梓兆
何谱
邸亮
栗光明
曾道炳
Zhao Xiaofei;Zhu Zizhao;He Pu;Di Liang;Li Guangming;Zeng Daobing(Department of General Surgery Center,Beijing You'an Hospital,Capital Medical University,Beijing 100069,China)
出处
《北京医学》
2025年第5期407-410,共4页
Beijing Medical Journal
