CAJ | 학술논문

目的研究肝门部胆管癌术前门静脉栓塞(PVE)前后血流动力学的变化,并分析其与非栓塞肝叶增生速度的关系.方法回顾性分析2008年4月至2009年12月第二军医大学东方肝胆外科医院收治的21例肝门部胆管癌患者的临床资料.在手术治疗前进行钢圈PVE治疗,在该治疗前和治疗后第3、7、14天采用彩色多普勒超声对门静脉的血流动力学指标进行测量、分析.计量资料比较采用Student t 检验,双变量正态分布数据相关分析采用线性相关分析方法.结果本组患者门静脉主干压力在PVE治疗后为(25.9±4.1)cm H2O(1 cm H2O=0.098 kPa),高于PVE治疗前的(22.4±4.1)cm H2O,升高幅度达到(3.5±2.5)cm H2O(t=-6.504,P＜0.05);门静脉非栓塞支血流速度在PVE治疗后加快,第7天血流速度达到峰值(26±9)cm/s;非栓塞肝叶增生速度与栓塞肝叶血管床占全肝体积比呈正相关(r=0.593,P＜0.05).结论栓塞的门静脉血管床范围越大,PVE诱导的非栓塞肝叶增生速度越快.
목적 연구간문부담관암술전문정맥전새(PVE)전후혈류동역학적변화,병분석기여비전새간협증생속도적관계.방법 회고성분석2008년4월지2009년12월제이군의대학동방간담외과의원수치적21례간문부담관암환자적림상자료.재수술치료전진행강권PVE치료,재해치료전화치료후제3、7、14천채용채색다보륵초성대문정맥적혈류동역학지표진행측량、분석.계량자료비교채용Student t 검험,쌍변량정태분포수거상관분석채용선성상관분석방법.결과 본조환자문정맥주간압력재PVE치료후위(25.9±4.1)cm H2O(1 cm H2O=0.098 kPa),고우PVE치료전적(22.4±4.1)cm H2O,승고폭도체도(3.5±2.5)cm H2O(t=-6.504,P＜0.05);문정맥비전새지혈류속도재PVE치료후가쾌,제7천혈류속도체도봉치(26±9)cm/s;비전새간협증생속도여전새간협혈관상점전간체적비정정상관(r=0.593,P＜0.05).결론 전새적문정맥혈관상범위월대,PVE유도적비전새간협증생속도월쾌.
Objective To detect the changes of hemodynamics in patients with portal vein embolization (PVE) before surgery for hilar cholangiocarcinoma, and analyze the relationship between hemodynamics and liver hypertrophy. Methods The clinical data of 21 patients with hilar cholangiocarcinoma who were admitted to the Eastern Hepatobiliary Surgery Hospital from April 2008 to December 2009 were retrospectively analyzed.Relevant hemodynamic variables were detected and analyzed before and 3, 7, 14 days after PVE. Data were processed using Student t test or linear correlation analysis. Results The main portal vein pressure after PVE was (25.9 ± 4.1 ) cm H2O ( 1 cm H2O = 0.098 kPa), which was ( 3.5 ± 2.5 ) cm H2O higher than that before PVE [( 22.4 ± 4.1 ) cm H2O] ( t = - 6. 504, P ＜ 0.05 ). The blood flow velocity in the non-embolized branch of portal vein increased after PVE, and reached peak [(26 ±9)cm/s] at the seventh day after PVE. A positive correlation was found between the hypertrophic rate of the non-embolized lobes and the ratio of embolized lobes to total liver volume ( r = 0. 593, P ＜ 0. 05 ). Conclusion Greater scope of the embolized vascular bed of portal vein induces higher hypertrophic rate of non-embolized liver.