Zhang Yu, Wen Tian-Fu, Chen Zhe-Yu, Yan Lü-Nan, Liang Guan-Lin, Li Guo, Zhang Xian-Hua, Ran Shun, Liao Zhi-Xua
Division of Liver Transplantation, West China Hospital, Sichuan University, Chengdu 610041, China.
Zhonghua Wai Ke Za Zhi. 2009 Jun 1;47(11):825-8.
To evaluate the predictive value of portal vein flow rate preoperative for portal vein thrombosis (PVT) after periesophagastric devascularization in hepatitis B cirrhosis-related portal hypertension.
From January 2007 to July 2008, 45 patients with portal hypertension caused by hepatitis B cirrhosis were performed splenectomy with peri-esophagogastric devascularization in the same medical group in West China Hospital of Sichuan University. The portal vein flow rate and the diameter of portal vein were measured with doppler sonography respectively before and after the operation. At the same time, the level of PT and PLT were detected. The weight of spleens were measured after operation.
Thirteen cases suffered from PVT postoperatively. Portal vein flow rate was significantly lower in patients with PVT postoperation than that in patients without PVT (P < 0.01). In patients with PVT (n = 13) postoperation, the preoperative portal vein flow rate was (19.5 +/- 5.3) cm/s. Among the 13 cases, there were 12 cases whose flow rate were lower than 25 cm/s, and 1 case whose flow rate was 32. 3 cm/s; In patients without PVT (n = 32), the preoperative portal vein flow rate was (9.6 +/- 8.0) cm/s. In patients with lower rate (n = 17), the incidence rate of PVT was 70.6%; in patients with higher rate (n = 28), the incidence rate of PVT was 3.6%. The incidence rate of PVT in patients with lower rate was significantly lower than patients with higher rate (P < 0.01). The diameter of portal vein in patients with PVT was significantly wider than patients without PVT. The diameter of portal vein was negative correlative with the portal vein flow rate. The value 25 cm/s was of diagnostic efficiency, the sensitivity was 92.3%, and specificity was 70.6%.
The portal vein flow rate preoperative can be used as an early predictor of portal vein thrombosis after periesophagastric devascularization in hepatitis B cirrhosis-related portal hypertension to give a guide to clinical work.
评估术前门静脉血流速度对乙型肝炎肝硬化相关性门静脉高压症贲门周围血管离断术后门静脉血栓形成（PVT）的预测价值。
2007年1月至2008年7月，四川大学华西医院同一医疗组对45例乙型肝炎肝硬化所致门静脉高压症患者行脾切除术加贲门周围血管离断术。分别于手术前后用多普勒超声测量门静脉血流速度及门静脉直径。同时，检测PT及PLT水平。术后测量脾脏重量。
术后13例发生PVT。术后发生PVT的患者门静脉血流速度显著低于未发生PVT的患者（P<0.01）。术后发生PVT的13例患者术前门静脉血流速度为（19.5±5.3）cm/s。13例中，血流速度低于25 cm/s的有12例，血流速度为32.3 cm/s的有1例；未发生PVT的32例患者术前门静脉血流速度为（9.6±8.0）cm/s。血流速度较低的17例患者中，PVT发生率为70.6%；血流速度较高的28例患者中，PVT发生率为3.6%。血流速度较低患者的PVT发生率显著低于血流速度较高患者（P<0.01）。发生PVT患者的门静脉直径显著宽于未发生PVT的患者。门静脉直径与门静脉血流速度呈负相关。25 cm/s这一数值具有诊断效能，敏感性为92.3%，特异性为70.6%。
术前门静脉血流速度可作为乙型肝炎肝硬化相关性门静脉高压症贲门周围血管离断术后门静脉血栓形成的早期预测指标，为临床工作提供指导。
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