肝豆状核变性合并脾功能亢进患者脾切除前后入肝血管血流变化的超声评价
The ultrasound evaluation of hemodynamic change of hepatic artery and portal vein in patients with hepatolenticular degeneration complicated with hypersplenism before and after splenectomy
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摘要: 目的:观测肝豆状核变性(HLD)肝硬化合并脾功能亢进患者脾切除前后入肝血管(肝动脉、门静脉)血流动力学改变情况。方法:应用彩色多普勒超声分别检测46例HLD脾切除患者术前和术后7 d和14 d入肝血管的血流参数,分析血流动力学参数改变情况。结果:脾切除术后7 d,门静脉主干内径、右支管腔内径均缩小,右支最大流速减慢,与术前比较差异均有统计学意义(P0. 05~P0. 01);术后14 d,门静脉右支最大血流速度明显较术后7 d上升(P0. 01);术前、术后7 d和14 d,门静脉主干和右支管腔内径差异均无统计学意义(0. 05)。术前、术后7 d和术后14 d右肝动脉峰值血流速度差异均有统计学意义(P0. 01),而阻力指数变化差异均无统计学意义(0. 05)。结论:HLD肝硬化合并脾功能亢进患者脾脏切除术后,入肝血管血流变化显著。Abstract: Objective: To observe the hemodynamic change of hepatic artery and portal vein in patients with hepatolenticular degeneration( HLD) complicated with hypersplenism before and after splenectomy. Methods: The hemodynamics of hepatic artery and portal vein in 46 patients with HLD complicated by hypersplenism were detected by color doppler ultrasound at preoperation and 7 and 14 days after splenectomy, all data were analyzed. Results: Compared with preoperation, the reducing diameter of main and right branch of portal vein and slowing of blood flow velocity were statistical significance at 7 days after splenectomy( P < 0. 05 - P < 0. 01) . The blood flow velocity of the right branch of portal vein at 14 days after splenectomy was higher than that in postoperative 7 days( P <0. 01) . There were not statistically significant in the diameter of main and right branch of portal vein and the peak velocity and resistance index of right hepatic artery between preoperation and postoperative 7 days and 14 days ( P > 0. 05) . Conclusions: The hemodynamic change of hepatic artery and portal vein in patients with HLD complicated with hypersplenism after splenectomy is significant.