CAJ | 학술논문

目的探讨门静脉高压患者肝静脉压力梯度与门静脉压的相关性及其临床价值. 方法经颈静脉肝内门体静脉分流术(TIPS)用球囊导管、压力传感器及测压仪测定46例患者的肝静脉楔压、自由压,及穿刺门静脉成功后分流道建立前、后门静脉压.Spearman's rank test分析肝静脉压力梯度与门静脉压的相关性. 结果 46例患者中,5例患者肝静脉压力梯度与门静脉压无相关性,门静脉造影检查显示其中3例患者肝内有明显的交通支直接分流道至肝段下腔静脉(即第三肝门静脉形成),另外2例患者明显脐静脉开放.41位患者纳入相关性分析结果显示,肝静脉压力梯度与门静脉压呈正相关(r=0.57,P＜0.001).急诊TIPS组的肝静脉压力梯度及门静脉压分别为(24.1±3.1) mmHg、(28.7±3.1) mmHg,与非急诊TIPS组的(23.5±4.1) mmHg和(31.4±4.9) mmHg比较,P值均＞0.05,差异无统计学意义.TIPS分流后,门静脉压为(17.1±4.7) mmHg,与分流前的(30.7±4.5)mmHg比较,显著降低,P＜ 0.001,差异有统计学意义.结论对绝大多数门静脉高压患者肝静脉压力梯度与门静脉压呈正相关,临床上可用肝静脉压力梯度反映门静脉压.
목적 탐토문정맥고압환자간정맥압력제도여문정맥압적상관성급기림상개치. 방법 경경정맥간내문체정맥분류술(TIPS)용구낭도관、압력전감기급측압의측정46례환자적간정맥설압、자유압,급천자문정맥성공후분류도건립전、후문정맥압.Spearman's rank test분석간정맥압력제도여문정맥압적상관성. 결과 46례환자중,5례환자간정맥압력제도여문정맥압무상관성,문정맥조영검사현시기중3례환자간내유명현적교통지직접분류도지간단하강정맥(즉제삼간문정맥형성),령외2례환자명현제정맥개방.41위환자납입상관성분석결과현시,간정맥압력제도여문정맥압정정상관(r=0.57,P＜0.001).급진TIPS조적간정맥압력제도급문정맥압분별위(24.1±3.1) mmHg、(28.7±3.1) mmHg,여비급진TIPS조적(23.5±4.1) mmHg화(31.4±4.9) mmHg비교,P치균＞0.05,차이무통계학의의.TIPS분류후,문정맥압위(17.1±4.7) mmHg,여분류전적(30.7±4.5)mmHg비교,현저강저,P＜ 0.001,차이유통계학의의.결론 대절대다수문정맥고압환자간정맥압력제도여문정맥압정정상관,림상상가용간정맥압력제도반영문정맥압.
Objective To evaluate the agreement and correlation between hepatic vein pressure gradient (HVPG) and portal vein pressure (PVP) in patients with portal hypertension,and explore their clinical value.Methods A total of 46 patients with portal hypertension were directly measured the free hepatic pressure,wedged hepatic pressure,portal vein pressure before and after TIPS therapy.The agreement and correlation of HVPG and PVP were analyzed,and explore their clinical value.Results There is no significant agreement or correlation between HVPG and PVP in 5 patients,whose third hilar have large communicating branches between portal vein and Inferior vena cava,or with obvious umbilical vein opened.The HVPGs were significantly agreed with portal vein pressure in other 41 patients.There is no significant difference of HVPG or PVP between earlyTIPS and not early-TIPS groups.In addition,the portal vein pressures after TIPS were significantly decreased compared with that before TIPS.Conclusion The HVPG can well show the PVP except these with obvious communicating branches between portal vein and Inferior vena cava in third hilar,and TIPS can effectively decrease the portal vein pressure in patients with portal hypertension.