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目的 :研究部分脾栓塞术 (PSE)对肝硬化门静脉高压症血液动力学的影响。方法 :6 8例肝硬化门静脉高压症并脾功能亢进患者 ,经股动脉插管对部分脾动脉用明胶海绵颗粒进行栓塞 ,应用彩色多普勒超声仪测量PSE前、后门静脉主干 (MPV)、脾静脉 (SV)内径及血流速度的变化 ,观察血流量的变化。结果 :PSE术后MPV内径由 1 .5 6± 0 .1 6cm减至 1 .38± 0 .1 9cm(p <0 .0 1 )。SV内径由 1 .2 7± 0 .2 0cm减至 0 .96± 0 .2 4cm(p <0 .0 1 )。MPV血流速度由 1 4 .39± 3.9cm .s-1 减至 1 2 .3± 4 .2cm .s-1 (p<0 .0 1 )。SV血流速度由 1 6 .7± 4 .4cm .s-1 减为 1 1 .6± 3.9cm .s-1 (p <0 .0 1 )。MPV血流量由 1 5 36±2 85ml.min-1 降至 1 1 31± 30 1ml.min-1 (p <0 .0 1 )。SV血流量由 1 0 4 7± 2 6 8ml.min-1 降至 5 46± 2 1 3ml.min-1 (p <0 .0 1 )。结论 :PSE后门脉主干及脾静脉内径较PSE前缩窄 ,血流速度减慢 ,门脉血流量减少 ,门脉压力降低。
Objective: To investigate the effect of partial splenic embolization (PSE) on hemodynamics in cirrhotic patients with portal hypertension. Methods: Sixty patients with portal hypertension and hypersplenism were enrolled. Some splenic arteries were embolized with gelatin sponge via femoral artery cannulation. The anterior and posterior portal vein (MPV) of PSE were measured by color Doppler sonography. Splenic vein (SV) diameter and blood flow velocity changes observed changes in blood flow. Results: The MPV diameter decreased from 1.56 ± 0.16cm to 1.38 ± 0.19cm (p <0.01) after PSE. SV inner diameter decreased from 1.2 7 ± 0.2 0 cm to 0 .96 ± 0.24 cm (p <0.01). The MPV blood flow velocity decreased from 14.39 ± 3.9 cm. S-1 to 12.3 ± 4. 2 cm. S-1 (p <0.01). The velocity of SV blood flow decreased from 16.7 ± 4. 4cm. S-1 to 11.6 ± 3.9cm. S-1 (p <0.01). The MPV blood flow decreased from 1 356 ± 2 85 ml.min-1 to 1 1 31 ± 30 1 ml.min-1 (p <0.01). SV blood flow dropped from 1047 ± 268 ml.min-1 to 546 ± 231 ml.min-1 (p <0.01). CONCLUSION: The diameter of posterior portal vein and splenic vein of PSE is narrower than that of PSE, the blood flow velocity is slowed, the portal blood flow is decreased and the portal pressure is decreased.