Reding P, Urbain D, Grivegnee A, Frere D
Hepatology. 1986 Jan-Feb;6(1):98-100. doi: 10.1002/hep.1840060118.
The portal venous-esophageal luminal pressure gradient may be more important than the absolute portal venous pressure in explaining hemorrhages caused by esophageal varices. A continuous recording of portal venous pressure and the esophageal luminal pressure enabled the authors to study the gradient between these pressures in 12 cirrhotic patients with varices of different size and under different circumstances, in particular inspiration, expiration, coughing and a Valsalva maneuver. A significant increase of portal venous pressure occurred during inspiration (+15%), coughing (+77%) and Valsalva maneuver (+157%). The value of portal venous-esophageal luminal pressure gradient increased during inspiration (+38%), coughing (+90%) and Valsalva maneuver (+69%) while it decreased during expiration (-14%).
在解释由食管静脉曲张引起的出血方面，门静脉-食管腔内压力梯度可能比门静脉绝对压力更为重要。对门静脉压力和食管腔内压力进行连续记录，使作者能够研究12例患有不同大小静脉曲张的肝硬化患者在不同情况下，特别是吸气、呼气、咳嗽和瓦尔萨尔瓦动作时这些压力之间的梯度。吸气时门静脉压力显著升高（+15%）、咳嗽时（+77%）和瓦尔萨尔瓦动作时（+157%）。门静脉-食管腔内压力梯度在吸气时升高（+38%）、咳嗽时（+90%）和瓦尔萨尔瓦动作时（+69%），而在呼气时降低（-14%）。
