Umehara M
First Department of Surgery, Nippon Medical School, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 1988 Nov;89(11):1869-78.
Hemodynamic states of portal hypertension with esophageal varices were studied by scintiphoto splenoportography (SSP) and left gastric angiographies in relation to endoscopic findings. The cases were classified into two groups by SSP. The flow of left gastric vein was hepatofugal in Group I (77.3%), and it was hepatopetal or "to and fro" in Group II (22.7%). Endoscopically, the varices were more severe in Group I than those in Group II. The diameter of left gastric vein was significantly larger in Group I. The values of K.ICG and liver function by blood analysis were also poor in Group I. Moreover, the cases with varices supplied by both left gastric artery and vein showed more severe endoscopic findings and history of hematemesis than those in the cases with varices supplied by left gastric artery alone. In conclusion, the results suggested that the flow of left gastric vein was closely related to the severity of esophageal varices.
通过闪烁脾门静脉造影(SSP)和胃左血管造影研究了伴有食管静脉曲张的门静脉高压血流动力学状态,并与内镜检查结果相关联。根据SSP将病例分为两组。第一组(77.3%)胃左静脉血流为离肝性,第二组(22.7%)为向肝性或“往返性”。在内镜检查中,第一组的静脉曲张比第二组更严重。第一组胃左静脉直径明显更大。第一组的吲哚氰绿(ICG)值和血液分析的肝功能指标也较差。此外,由胃左动脉和静脉供血的静脉曲张病例比仅由胃左动脉供血的静脉曲张病例内镜检查结果更严重,且有呕血史。总之,结果表明胃左静脉血流与食管静脉曲张的严重程度密切相关。