部分脾动脉栓塞术对肝硬化门静脉高压症血流动力学的影响

摘要

目的 探讨部分脾动脉栓塞术(PSE)治疗肝硬化门静脉高压症的临床疗效及应用价值.方法 23例不同原因肝硬化门静脉高压患者行PSE治疗,PSE术前及术后1周、1、3、6个月彩色多普勒分别检测患者门静脉和脾静脉的内径、血流速度,计算血流量,并与PSE术前配对分析.结果 术后各期患者脾静脉、门静脉血流速度及血流量较术前降低(P＜0.05)；脾静脉内径术后各期与术前相比明显缩小(P＜0.05)；而门静脉主干内径术后6个月内缩小不明显(P＞0.05).结论 PSE能有效的降低门静脉压力.%Objective To investigate the clinical efficacy and therapeutic value of partial splenic artery embolization ( PSE ) for treating portal hypertension in patients with liver cirrhosis. Methods Twenty — three patients diagnosed with liver cirrhosis of different etiology and with portal hypertension were treated with PSE. Diameter and blood flow velocity of the portal vein (PV) and splenic vein (SV) were measured by color Doppler ultrasound before PSE ( baseline) and after PSE ( postoperative week 1 and months 1,3, and 6). Statistical significance of differences was assessed by paired t - test. Results Both the PV and SV blood flow velocities were significantly enhanced after PSE ( all postoperative times vs. baseline, P < 0. 05 ) . SV diameter was significantly reduced after PSE ( all postoperative times vs. baseline, P < 0. 05). PV diameter, however, was not significantly reduced at six months after PSE (vs. baseline, P≥0.05). Conclusion PSE can reduce portal vein pressure in patients with liver cirrhosis.