贲门周围血管离断术前后肝硬化病人肝脏血流灌注的改变

目的：利用肝脏阻抗血流图探讨肝硬化门静脉高压症病人的肝脏血流灌注改变和贲门周围血管离断术对肝脏血流灌注的影响。方法：选取22例肝硬化门静脉高压症病人，分别在术前1周、术后2周检测肝血流阻抗改变，同时用Doppler检测门静脉血流动力学变化。结果：阻抗血流图表明，和对照XEG相比，门静脉高压症病人的肝动脉、门静脉向肝血流灌注明显下降，总肝灌注量降低；门静脉高压症病人术后门静脉向肝灌注增加，肝动态的向肝灌注无显著改变。Doppler测定表明门静脉高压症病人的门静脉直径增加，血流量增加，但血流速度无显著差别；术后门静脉血流动力学与术前无差别。结论：肝硬化病人肝动脉、门静脉向肝有效血流灌注都降低，肝脏总血流量下降；贲门周围血管离断术增加大部分病人的门静脉向肝血流灌注，但对肝动脉的向肝灌注无显著影响；肝脏阻抗血流图作为反映肝脏动态血流灌注的无创性检查，对于评价肝硬化病人的肝脏血流及评价手术对肝脏血流动力学的影响有一定的价值。

Changes of liver blood perfusion of portal hypertensive patients before and after pericardial devascularization

Objective To evaluate the changes of hepatic blood perfusion of liver cirrhosis patients and the role of pericardial devascularization (PCDV)on them.Methods Hepatic artery and portal vein perfusions of 22 liver cirrhotic patients (LC) pre and post P CDV compared with control were evaluated with rheohepatogram(RHG) and ultrasonogram(USG).Results Compared with control,both hepatic and portal effective perfusion of LC were decreased on RHG, PCDV could increase portal perfusion of LC patients without significant effect on hepatic artery.USG showed that portal vein diameter and blood quantity of LC increased and PCDV didn't influence liver perfusion;No correlation between RHG and USG parameters were seen by STATA analysis. Conclusions RHG is an effective way to evaluate comprehensive blood perfusion of cirrhotic livers,the effect of operation on blood perfusion and prognosis.