Yano K, Okimura E, Shimizu R, Uchiyama T, Yoshino S, Hazama S, Murakami T, Suzuki T
Second Dept. of Surgery, Yamaguchi University School of Medicine.
Gan To Kagaku Ryoho. 1989 Aug;16(8 Pt 2):2982-5.
In a case of hepatocellular carcinoma, complicated with celiac arterial constriction, for which resection was impossible, we measured the blood flow in the hepatic artery using an ultrasonic, transit-time rheometer during surgery, and consequently inserted a reservoir safely. The measurement of the blood flow in this case demonstrated that the proper hepatic artery was provided with blood from superior mesenteric artery by the gastroduodenal artery and that the blood flow of the common hepatic artery was directed to the root part of the celiac artery. Moreover, because blood flow through the proper hepatic artery was greater while clamping the common hepatic artery than the gastroduodenal artery, cannulation was carried out from the common hepatic artery. Postoperatively, when recombinant interleukin-2(rIL-2) was infused from the reservoir, the tumor disappeared on imaging pictures, and the level of AFP (which was high preoperatively) was reduced, which was thus judged as a complete response. These results indicated the usefulness of measurement of blood flow in surgery of inserting a reservoir in cases with abnormal blood circulatory dynamics.
在一例无法进行切除的合并腹腔动脉狭窄的肝细胞癌病例中，我们在手术过程中使用超声渡越时间血流计测量了肝动脉血流，并成功安全地植入了一个储液器。该病例的血流测量结果表明，肝固有动脉通过胃十二指肠动脉接受来自肠系膜上动脉的血液供应，肝总动脉的血流方向朝向腹腔动脉根部。此外，由于夹闭肝总动脉时肝固有动脉的血流比夹闭胃十二指肠动脉时更大，所以从肝总动脉进行了插管。术后，当从储液器注入重组白细胞介素-2（rIL-2）时，影像学检查显示肿瘤消失，术前升高的甲胎蛋白（AFP）水平降低，因此判断为完全缓解。这些结果表明，在血液循环动力学异常的病例中，血流测量对于植入储液器的手术具有重要价值。
