中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
23期
33-35
,共3页
癌,肝细胞%超声检查,多普勒,彩色%门静脉%肝动脉
癌,肝細胞%超聲檢查,多普勒,綵色%門靜脈%肝動脈
암,간세포%초성검사,다보륵,채색%문정맥%간동맥
Carcinoma,hepatocellular%Ultrasonography,Doppler,color%Portal vein%Hepatic artery
目的 探讨肝细胞癌合并门静脉主干癌栓时的肝动脉血流动力学变化.方法 将60例肝细胞癌合并门静脉主干癌栓患者根据癌栓对门静脉主干的阻塞程度分为部分性阻塞组和完全性阻塞组,每组30例,应用彩色多普勒超声测量肝固有动脉内径( PHA-D)、收缩期最大血流速度(Vmax)以及阻力指数(RI),并与80例肝细胞癌无门静脉癌栓患者(肝癌组)和20例健康体检者(对照组)作对比.结果 对照组、肝癌组、部分性阻塞组、完全性阻塞组PHA-D分别为(0.33±0.05)、(0.44±0.04)、(0.45±0.04)、(0.61 ±0.07) cm,Vmax分别为(31.32±9.31)、(66.76±20.34)、(68.16±21.96)、(132.65±38.84) cm/s,RI分别为0.75±0.08、0.68±0.13、0.65±0.11、0.55±0.10.肝癌组、部分性阻塞组、完全性阻塞组PHA-D、Vmax、RI与对照组比较差异均有统计学意义(P＜0.01或＜0.05)；完全性阻塞组PHA-D、Vmax、RI与肝癌组和部分性阻塞组比较差异均有统计学意义(P＜0.01).结论 肝细胞癌合并门静脉主干癌栓时,肝动脉血流量明显代偿性增加,RI明显减低,但肝动脉血流动力学的改变主要取决于癌栓对门静脉主干的阻塞程度,而并非取决于门静脉癌栓的有无.
目的 探討肝細胞癌閤併門靜脈主榦癌栓時的肝動脈血流動力學變化.方法 將60例肝細胞癌閤併門靜脈主榦癌栓患者根據癌栓對門靜脈主榦的阻塞程度分為部分性阻塞組和完全性阻塞組,每組30例,應用綵色多普勒超聲測量肝固有動脈內徑( PHA-D)、收縮期最大血流速度(Vmax)以及阻力指數(RI),併與80例肝細胞癌無門靜脈癌栓患者(肝癌組)和20例健康體檢者(對照組)作對比.結果 對照組、肝癌組、部分性阻塞組、完全性阻塞組PHA-D分彆為(0.33±0.05)、(0.44±0.04)、(0.45±0.04)、(0.61 ±0.07) cm,Vmax分彆為(31.32±9.31)、(66.76±20.34)、(68.16±21.96)、(132.65±38.84) cm/s,RI分彆為0.75±0.08、0.68±0.13、0.65±0.11、0.55±0.10.肝癌組、部分性阻塞組、完全性阻塞組PHA-D、Vmax、RI與對照組比較差異均有統計學意義(P＜0.01或＜0.05)；完全性阻塞組PHA-D、Vmax、RI與肝癌組和部分性阻塞組比較差異均有統計學意義(P＜0.01).結論 肝細胞癌閤併門靜脈主榦癌栓時,肝動脈血流量明顯代償性增加,RI明顯減低,但肝動脈血流動力學的改變主要取決于癌栓對門靜脈主榦的阻塞程度,而併非取決于門靜脈癌栓的有無.
목적 탐토간세포암합병문정맥주간암전시적간동맥혈류동역학변화.방법 장60례간세포암합병문정맥주간암전환자근거암전대문정맥주간적조새정도분위부분성조새조화완전성조새조,매조30례,응용채색다보륵초성측량간고유동맥내경( PHA-D)、수축기최대혈류속도(Vmax)이급조력지수(RI),병여80례간세포암무문정맥암전환자(간암조)화20례건강체검자(대조조)작대비.결과 대조조、간암조、부분성조새조、완전성조새조PHA-D분별위(0.33±0.05)、(0.44±0.04)、(0.45±0.04)、(0.61 ±0.07) cm,Vmax분별위(31.32±9.31)、(66.76±20.34)、(68.16±21.96)、(132.65±38.84) cm/s,RI분별위0.75±0.08、0.68±0.13、0.65±0.11、0.55±0.10.간암조、부분성조새조、완전성조새조PHA-D、Vmax、RI여대조조비교차이균유통계학의의(P＜0.01혹＜0.05)；완전성조새조PHA-D、Vmax、RI여간암조화부분성조새조비교차이균유통계학의의(P＜0.01).결론 간세포암합병문정맥주간암전시,간동맥혈류량명현대상성증가,RI명현감저,단간동맥혈류동역학적개변주요취결우암전대문정맥주간적조새정도,이병비취결우문정맥암전적유무.
Objective To investigate the hemodynamic changes of the proper hepatic artery (PHA) in hepatocellular carcinoma (HCC) and portal stem vein tumor thrombus.Methods Sixty HCC and portal stem vein tumor thrombus patients were divided into partial occlusion group and completely occlusion group with 30 patients each.Eighty HCC patients without portal stem vein tumor thrumbus were in HCC group and 20 health cases were in control group.Color Doppler ultrasound was used to measure the diameter of PHA (PHA-D),systolic maximal velocity (Vmax) and resistant index (RI) of PHA.Results PHA-D in control group,HCC group,partial occlusion group and completely occlusion group was (0.33 ±0.05),(0.44 ±0.04),(0.45±0.04),(0.61±0.07)cm,Vmax was (31.32±9.31),(66.76±20.34),(68.16±21.96),( 132.65 ± 38.84 ) cm/s,RI was 0.75 ± 0.08,0.68 ± 0.13,0.65 ± 0.11,0.55 ± 0.10,respectively.The levels of PHA-D,Vmax and RI in HCC group,partial occlusion group and completely occlusion group had significant difference compared with those in control group (P ＜ 0.01 or ＜ 0.05 ).The levels of PHA-D,Vmax and RI in completely occlusion group had significant difference compared with those in HCC group,partial occlusion group(P＜ 0.01 ). Conclusions The blood flux obviously ascends compensatorily in HCC with portal stem vein tumor thrombus,RI obviously descends.But it is the occlusive nature of the tumor thrombus that is crucial to the hemodynamic change of the proper hepatic artery.
