中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2011年
2期
154-157
,共4页
肝移植%活体供者%脾切除术%血流动力学
肝移植%活體供者%脾切除術%血流動力學
간이식%활체공자%비절제술%혈류동역학
Liver transplantation%Living donors%Splenectomy%Hemodynamics
目的 研究活体肝移植联合脾脏切除术后患者肝脏血流动力学变化情况.方法 回顾性分析2006年8月至2009年3月开展的66例活体肝移植手术患者的病例资料,肝移植时行脾切除者共22例(脾切除组),年龄(45±11)岁,按1∶2的比例随机抽取同期具有可比性的肝移植时未行脾切除的44例患者作为对照组,年龄(44±10)岁,对比分析移植术后两组间患者肝脏血流动力学变化.结果 术前、术后1 d保留脾脏组和脾切除组门静脉血流速度分别为(12±2)cm/s和(11±3)cm/s、(35±18)cm/s和(32±17)cm/s,两组术后门静脉血流速度均显著大于术前水平(P＜0.05),术后1周两组肝右静脉血流速度分别为(44±18)cm/s和(31±15)cm/s,术后保留脾脏组肝右静脉血流速度明显大于脾切除组(P＜0.05),术后2周两组肝动脉血流速度分别为(18±8)cm/s和(26±7)cm/s,肝动脉阻力系数分别为0.66±0.13和0.57±0.12,1周后脾切除组肝动脉血流速度明显大于保留脾脏组(P＜0.05),而肝动脉阻力系数明显小于后者(P＜0.05).结论 活体肝移植联合脾切除术后肝脏的血流动力学情况优于单纯活体肝移植术式.
目的 研究活體肝移植聯閤脾髒切除術後患者肝髒血流動力學變化情況.方法 迴顧性分析2006年8月至2009年3月開展的66例活體肝移植手術患者的病例資料,肝移植時行脾切除者共22例(脾切除組),年齡(45±11)歲,按1∶2的比例隨機抽取同期具有可比性的肝移植時未行脾切除的44例患者作為對照組,年齡(44±10)歲,對比分析移植術後兩組間患者肝髒血流動力學變化.結果 術前、術後1 d保留脾髒組和脾切除組門靜脈血流速度分彆為(12±2)cm/s和(11±3)cm/s、(35±18)cm/s和(32±17)cm/s,兩組術後門靜脈血流速度均顯著大于術前水平(P＜0.05),術後1週兩組肝右靜脈血流速度分彆為(44±18)cm/s和(31±15)cm/s,術後保留脾髒組肝右靜脈血流速度明顯大于脾切除組(P＜0.05),術後2週兩組肝動脈血流速度分彆為(18±8)cm/s和(26±7)cm/s,肝動脈阻力繫數分彆為0.66±0.13和0.57±0.12,1週後脾切除組肝動脈血流速度明顯大于保留脾髒組(P＜0.05),而肝動脈阻力繫數明顯小于後者(P＜0.05).結論 活體肝移植聯閤脾切除術後肝髒的血流動力學情況優于單純活體肝移植術式.
목적 연구활체간이식연합비장절제술후환자간장혈류동역학변화정황.방법 회고성분석2006년8월지2009년3월개전적66례활체간이식수술환자적병례자료,간이식시행비절제자공22례(비절제조),년령(45±11)세,안1∶2적비례수궤추취동기구유가비성적간이식시미행비절제적44례환자작위대조조,년령(44±10)세,대비분석이식술후량조간환자간장혈류동역학변화.결과 술전、술후1 d보류비장조화비절제조문정맥혈류속도분별위(12±2)cm/s화(11±3)cm/s、(35±18)cm/s화(32±17)cm/s,량조술후문정맥혈류속도균현저대우술전수평(P＜0.05),술후1주량조간우정맥혈류속도분별위(44±18)cm/s화(31±15)cm/s,술후보류비장조간우정맥혈류속도명현대우비절제조(P＜0.05),술후2주량조간동맥혈류속도분별위(18±8)cm/s화(26±7)cm/s,간동맥조력계수분별위0.66±0.13화0.57±0.12,1주후비절제조간동맥혈류속도명현대우보류비장조(P＜0.05),이간동맥조력계수명현소우후자(P＜0.05).결론 활체간이식연합비절제술후간장적혈류동역학정황우우단순활체간이식술식.
Objective To investigate the changes of hepatic hemodynamics in patients with splenectomy plus living donor liver transplantation (LDLT). Methods The data of 66 patients received LDLT from August 2006 to March 2009 were analyzed retrospectively:22 cases received splenectomy with LDLT (splenectomy group) and aged (45±11) years. Forty-four comparable cases received LDLT only in the mean time were selected as control group and aged (44±10) years. Comparative analysis was performed between the two groups with respect to the changes of hepatic hemodynamics after transplantation.Results Blood velocity in portal vein in control group and splenectomy group at 1 day before and after the transplantation were (12 ±2) cm/s vs. (11+3) cm/s, (35±18) cm/s vs. (32 ± 17) cm/s, respectively. Postoperative blood velocity in portal vein in both groups increased significantly than the preoperative level ( P ＜ 0.05).Blood flow velocity in right hepatic vein in both groups at 1 week after the treatment were (44±18)cm/s and (31±15) cm/s(P＜0.05), respectively. Blood flow velocity in hepatic artery in both groups 2 weeks after the operation were (18±8) cm/s vs. (26±7) cm/s(P＜0.05) and resistance coefficient of hepatic artery were 0.66±0.13 vs. 0.57±0.12 (P＜0.05), respectively. Conclusion Hepatic hemodynamics in patients received LDLT plus splenectomy is superior to that in patients received LDLT only.
