【摘要】 目的:定量研究脾脏动脉、静脉及门静脉在部分性脾动脉栓塞(PSE)术前后的血液动力学变化情况。方法:术前、术后即刻、术后1周分别测定脾脏动脉、静脉及门静脉血液动力学各项指标。结果:20例患者的脾动脉PSV、EDV、MV,脾静脉MV在PSE术后均显著降低(P<0.01);脾动、静脉血管截面积S术后显著减小(P<0.01);脾动静脉及门静脉血流量Q术后均显著降低(P<0.01)。术后1周PSV、EDV和MV、脾静脉S、血流量Q较术后即刻又有明显恢复(P<0.01);S/D、PI、RI术后显著增加;术后脾静脉血流量减少程度与脾脏栓塞程度成正相关,r=0.545(P<0.05);结论:PSE术能有效减少门静脉血流量,缓解门脉高压,从而降低上消化道大出血的风险。但门静脉的血流量减少程度与脾脏栓塞程度无相关性。更多还原

【Abstract】 Objective:With ultrasonic Doppler quantitative study of the changes of hemodynamics in splenic artery(SA), splenic vein (SV) and portal vein(PV)at both pre-and post-partial splenic embolization(PSE).Methods:Each index of hemodynamics(including PSV,EDV, MV, area and blood flow volume of the SA,MV,area and blood flow volume of the SV,and blood flow volume of the PV)were measured by using ultrasonic Doppler in 20 cases with clinically proved hypersplenism at pre-PSE,post-PSE immediately and 1 week after PSE.Results:The blood flow velocity(BFV) of SA of the 20 cases(including PSV,EDV and MV)and the mean blood flow velocity of SV reduced significantly (P<0.01) at post-PSE. Area of SA and SV reduced significantly (P<0.01)at post-PSE.The blood flow volume of SA,SV and PV reduced significantly (P<0.01) at post-PSE.A week after PSE,though the PSV,EDV and MV of SA,area of SV, blood flow volume of SA,SV and PV increased significantly compared with post-PSE immediately (P<0.01),these indexes reduced significantly compared with pre-PSE (P<0.01).Three indexes(including S/D,PI,RI) reflecting the resistance of SA were increased significantly after PSE (P<0.01).The changes of those indexes were notsignificant in a week (P>0.05)compared with post-PSE immediately. The decreased degrees of blood flow volume of SV were positively related to the percentage of splenic embolization (r=0.545,P<0.05),but there has no relationship between the decreased degrees of blood flow volume of PV and the percentage of splenic embolization (r=0.084,P>0.05).Conclusion:The blood flow volume of PV would decrease significantly after PSE.The portal hypertension would be relieved.The risk of upper gastrointestinal hemorrhage would be depressed, but the changes of blood flow volume of PV were not related to the percentage of splenic embolization.更多还原