目的 探讨食管胃底静脉曲张硬化疗法及组织胶治疗对肝硬化患者门动脉血流动力学及肝功能的影响.方法 收集40例肝硬化门脉高压症合并食管胃底静脉曲张患者,将其分为单纯硬化剂组、单纯组织黏合剂注射组及硬化加黏合剂组,测定治疗前后患者的门静脉血流动力学指标及肝功能指标,进行统计分析.结果 三组患者治疗1周后门静脉血管内径均较治疗前增加,但差异无统计学意义(均P＞0.05),平均血流速度与血流量均较治疗前显著增加(均P＜0.05)；硬化加黏合剂组对门脉血流动力学改变明显高于其余两组(P＜0.05),单纯硬化剂组稍高于单纯黏合剂组,但差异无统计学意义.三组患者反映肝脏功能的指标中白蛋白及血浆凝血酶原时间术前术后差异均有统计学意义(均P＜ 0.05).结论 食管胃底静脉曲张硬化疗法及组织黏合剂治疗可以增加门静脉血流,可能不会明显加重门静脉高压,有利于肝脏合成功能的恢复和肝脏的血液供应.%Objective To investigate the influence of sclerotherapy, endoscopic injection of tissue adhesive therapy on the portal hemodynamics and liver function in patient with liver cirrhosis. Methods Forty patients with liver cirrhosis were divided into three groups: group A (treated by sclerotherapy alone), group B (treated by endoscopic injection of tissue adhesive therapy alone), and group C (treated by endoscopic injection of tissue adhesive therapy combined with sclerotherapy). The portal hemodynamics and liver function were measured before and after treatment by color doppler flow imaging, as well as the changes in albumin, total bilirubin, prothrombin time, and ALT. Results The results showed that the portal vein diameter (PD) in the three groups increased after one week of treatment, but showed no statistically significant difference with that before treatment (P>0.05). The mean blood flow velocity and portal flow volume (PQ) in the three groups increased significantly after treatment (P<0.05), which is significantly higher in group C than group A and group B (P<0.05). Serum-album and prothrombin time in the three groups showed statistically significant difference before and after treatment. Conclusion Sclerotherapy combined with endoscopie injection of tissue adhesive therapy can increase blood flow in portal vein, but not increase the pressure of portal vein significantly, which contribute to the blood supply and the synthesis function of liver.
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