Gattoni F, Baldini U, Raiteri R, Pompili G G, Pozzato C, Uslenghi C
Istituto di Scienze Radiologiche, Università, Ospedale San Paolo, Milano.
Radiol Med. 1992 Jul-Aug;84(1-2):54-8.
Seventy-two patients (52 males and 20 females, mean age: 50.6 years) were studied. They had undergone distal splenorenal shunts according to Warren and its modifications for portal hypertension. All patients were examined with digital and/or conventional angiography preoperatively and 15 days postoperatively. Preoperative and postoperative angiography was employed to evaluate the changes in vessel diameters including the hepatic, splenic and superior mesenteric arteries, the splenic, superior mesenteric and portal veins; the length of the main axis of the spleen was also measured. Furthermore, the degree of hepatic portal venous perfusion was evaluated according to the degree of portomesenteric-gastrosplenic disconnection. After surgery, the length of the main axis of the spleen is reduced and the hepatic artery diameter is increased, which are both signs of preserved hepatic flow and of reduced hypertension in the splanchnic venous system. The postoperative degrees of portal perfusion were correlated with the degrees of disconnection. In conclusion, the role is emphasized of early angiographic examinations after distal portosystemic shunts according to Warren to evaluate postoperative hemodynamic changes.
对72例患者（52例男性，20例女性，平均年龄：50.6岁）进行了研究。他们根据沃伦术式及其改良术式接受了远端脾肾分流术以治疗门静脉高压症。所有患者在术前及术后15天均接受了数字血管造影和/或传统血管造影检查。采用术前和术后血管造影来评估包括肝动脉、脾动脉和肠系膜上动脉，脾静脉、肠系膜上静脉和门静脉在内的血管直径变化；还测量了脾脏长轴的长度。此外，根据门静脉肠系膜-胃脾分流程度评估肝门静脉灌注程度。术后，脾脏长轴长度缩短，肝动脉直径增加，这两者均为肝血流保留及内脏静脉系统高血压减轻的征象。术后门静脉灌注程度与分流程度相关。总之，强调了按照沃伦术式进行远端门体分流术后早期血管造影检查在评估术后血流动力学变化方面的作用。
