CAJ | 학술논문

目的：应用超声检查技术了解肝豆状核变性（HLD）并发脾功能亢进症患者脾切除前后肝脏血流改变的特点。方法使用彩色多普勒超声检测108例HLD患者在脾脏切除前后门静脉右支内径、最大血流流速、肝右动脉最大血流流速和阻力指数变化。结果 HLD患者脾切除后门静脉右支内径为（8.48±1.88）mm，与脾切除前[（9.09±2.16）mm，P>0.05]比，差异无统计学意义；脾切除后门静脉右支最大血流流速（Vmax）为（19.40±3.41）cm/s，显著低于脾切除前水平[（23.47±5.78）cm/s，P<0.01]；脾切除后肝右动脉最大血流流速（PSV）为（60.71±11.85） cm/s，显著快于脾切除前水平[（40.33±8.83）cm/s，P<0.01]；脾切除后肝右动脉阻力指数（RI）为（0.66±0.05），明显高于脾切除前水平[（0.63±0.05），P<0.01]。结论 HLD并发脾功能亢进症患者在脾切除术后门静脉系统、肝动脉系统血供发生了明显的变化，使用超声检查技术对其进行监测可为临床评估患者术后肝功能情况提供依据。
목적：응용초성검사기술료해간두상핵변성（HLD）병발비공능항진증환자비절제전후간장혈류개변적특점。방법사용채색다보륵초성검측108례HLD환자재비장절제전후문정맥우지내경、최대혈류류속、간우동맥최대혈류류속화조력지수변화。결과 HLD환자비절제후문정맥우지내경위（8.48±1.88）mm，여비절제전[（9.09±2.16）mm，P>0.05]비，차이무통계학의의；비절제후문정맥우지최대혈류류속（Vmax）위（19.40±3.41）cm/s，현저저우비절제전수평[（23.47±5.78）cm/s，P<0.01]；비절제후간우동맥최대혈류류속（PSV）위（60.71±11.85） cm/s，현저쾌우비절제전수평[（40.33±8.83）cm/s，P<0.01]；비절제후간우동맥조력지수（RI）위（0.66±0.05），명현고우비절제전수평[（0.63±0.05），P<0.01]。결론 HLD병발비공능항진증환자재비절제술후문정맥계통、간동맥계통혈공발생료명현적변화，사용초성검사기술대기진행감측가위림상평고환자술후간공능정황제공의거。
Objective To observe the changes of hepatic hemodynamics by ultrasonography before and after splenectomy in patients with hepatolenticular degeneration (HLD) complicated by hypersplenism. Methods 108 patients with HLD were recruited and they all received color doppler ultrasonography before and after splenecto-my. The inner diameter and maximum velocity of right portal vein (Vmax),peak systolic velocity (PSV) and re-sistance index(RI) of right hepatic artery were recorded and analyzed. Results The inner diameters of right por-tal vein before and after splenectomy were (9.09±2.16) mm and (8.48±1.88) mm,respectively(P>0.05);Vmax of right portal vein after splenectomy declined remarkably as compared with that before splenectomy [(19.40 ±3.41) cm/s vs.(23.47±5.78) cm/s,P<0.01];PSV and RI of right hepatic artery after splenectomy were significantly higher than those before surgery [(60.71 ±11.85) cm/s vs. (40.33 ±8.83) cm/s and (0.66 ±0.05) vs. (0.63 ±0.05),P<0.01 for both]. Conclusion Prominent changes in blood supply of portal venous system and hepatic artery system in patients with HLD and hypersplenism take place after splenectomy. Ultrasonography can monitor the changes of hepatic hemodynamics and provide information for the evaluation of patients’liver function.