中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2014年
12期
927-929
,共3页
王连才%李德宇%陈香丽%余海波%高春辉%穆森茂%董亚东
王連纔%李德宇%陳香麗%餘海波%高春輝%穆森茂%董亞東
왕련재%리덕우%진향려%여해파%고춘휘%목삼무%동아동
Budd-Chiari综合征%人工血管%静脉压
Budd-Chiari綜閤徵%人工血管%靜脈壓
Budd-Chiari종합정%인공혈관%정맥압
Budd-Chiari syndrome%Blood vessel prosthesis%Venous pressure
目的 探讨腔房转流术(atrial caval shunting,ACS)治疗Ⅱ型布加综合征(Budd-Chiari syndrome,BCS)手术前后下腔静脉压力(inferior vena cava pressure,IVCP)的变化规律及其与术后血管通畅率的关系.方法 回顾性分析河南省人民医院1992年1月至2010年1月应用腔-房人工血管转流术治疗的209例Ⅱ型BCS患者的临床资料,检测术中开放人工血管前后IVCP、右心房压力(rightatrial pressure,RAP)及自由门静脉压力(portal free pressure,PFP)变化,采用t检验比较人工血管开放前后IVCP、RAP、PFP的压力变化;定期彩超检查人工血管通畅情况,应用Kaplan-Meier法分析IVCP和术后人工血管通畅率间的相关性.结果 开放人工血管后IVCP、PFP显著下降(P＜0.05),开放人工血管后RAP显著升高(t=0.52,P＜0.05);人工血管开放后IVCP下降幅度较低者(＜1 kPa)的术后人工血管通畅率显著低于IVCP下降幅度较高者(≥1 kPa) (P ＜0.05).结论 ACS术中人工血管循环开放后,IVCP下降幅度较大者术后人工血管通畅率较高.
目的 探討腔房轉流術(atrial caval shunting,ACS)治療Ⅱ型佈加綜閤徵(Budd-Chiari syndrome,BCS)手術前後下腔靜脈壓力(inferior vena cava pressure,IVCP)的變化規律及其與術後血管通暢率的關繫.方法 迴顧性分析河南省人民醫院1992年1月至2010年1月應用腔-房人工血管轉流術治療的209例Ⅱ型BCS患者的臨床資料,檢測術中開放人工血管前後IVCP、右心房壓力(rightatrial pressure,RAP)及自由門靜脈壓力(portal free pressure,PFP)變化,採用t檢驗比較人工血管開放前後IVCP、RAP、PFP的壓力變化;定期綵超檢查人工血管通暢情況,應用Kaplan-Meier法分析IVCP和術後人工血管通暢率間的相關性.結果 開放人工血管後IVCP、PFP顯著下降(P＜0.05),開放人工血管後RAP顯著升高(t=0.52,P＜0.05);人工血管開放後IVCP下降幅度較低者(＜1 kPa)的術後人工血管通暢率顯著低于IVCP下降幅度較高者(≥1 kPa) (P ＜0.05).結論 ACS術中人工血管循環開放後,IVCP下降幅度較大者術後人工血管通暢率較高.
목적 탐토강방전류술(atrial caval shunting,ACS)치료Ⅱ형포가종합정(Budd-Chiari syndrome,BCS)수술전후하강정맥압력(inferior vena cava pressure,IVCP)적변화규률급기여술후혈관통창솔적관계.방법 회고성분석하남성인민의원1992년1월지2010년1월응용강-방인공혈관전류술치료적209례Ⅱ형BCS환자적림상자료,검측술중개방인공혈관전후IVCP、우심방압력(rightatrial pressure,RAP)급자유문정맥압력(portal free pressure,PFP)변화,채용t검험비교인공혈관개방전후IVCP、RAP、PFP적압력변화;정기채초검사인공혈관통창정황,응용Kaplan-Meier법분석IVCP화술후인공혈관통창솔간적상관성.결과 개방인공혈관후IVCP、PFP현저하강(P＜0.05),개방인공혈관후RAP현저승고(t=0.52,P＜0.05);인공혈관개방후IVCP하강폭도교저자(＜1 kPa)적술후인공혈관통창솔현저저우IVCP하강폭도교고자(≥1 kPa) (P ＜0.05).결론 ACS술중인공혈관순배개방후,IVCP하강폭도교대자술후인공혈관통창솔교고.
Objective To investigate the change of inferior vena cava pressure (IVCP) in type Ⅱ Budd-Chiari syndrome patients undergoing atrial caval shunting and its relationship with postoperative artificial blood vessel (ABV) patency rate.Methods We recruited 209 patients who had undergone atrial caval shunting for type Ⅱ Budd-Chiari syndrome and evaluated IVCP,right atrial pressure (RAP) and free portal vein pressure (PFP) before and after ABV opening.Presure changes were compared by t-test.These patients were followed up by color Doppler ultrasonograthy for ABV patency.The correlation between IVCP and postoperative ABV patency were analyzed By Kaplan-Meier test.Results IVCP (t =0.56,P ＜ 0.05)and PFP (t =0.72,P ＜ 0.05) decreased and RAP increased significantly after ABV opening (t =0.52,P ＜ 0.05).Follow up result showed that ABV patency rate was lower in patients with IVCP descent ＜ 1 kPa than those with IVCP descent ＞ 1 kPa (P ＜ 0.05).Conclusions Significant IVCP descent correlates with high ABV patency rate after atrial caval shunting in type Ⅱ Budd-Chiari syndrome patients.
