Rypins E B, Sarfeh I J
J Surg Res. 1984 Aug;37(2):119-22. doi: 10.1016/0022-4804(84)90171-9.
Direction of portal flow after small diameter portacaval H graft has been found to significantly correlate with postshunt portasystemic encephalopathy rates. While some patients maintaining prograde portal flow were found to have a lower incidence of portasystemic encephalopathy, it has been suggested that high portal pressures are responsible for minimizing this complication. If both statements are true, then postshunt pressures should be higher in patients with prograde flow and in encephalopathy. Portal pressure and portal flow patterns were determined by shunt cannulation and fluoroscopy in 16 patients fully recovered from operation. Patients were screened for portasystemic encephalopathy over a 6- to 24-month period (average 12 months) at which time shunt patency was documented. Portal pressures were similar in patients with and without portasystemic encephalopathy and in patients with and without prograde flow. These results do not support the concept that protal pressure is an important determinant of portasystemic encephalopathy rates or flow patterns after 10-mm portacaval H graft.
小直径门腔H型分流术后门静脉血流方向已被发现与分流后门体性脑病发生率显著相关。虽然发现一些维持正向门静脉血流的患者门体性脑病发生率较低，但有人认为高门静脉压力是使这种并发症降至最低的原因。如果这两种说法都是正确的，那么正向血流患者和患有脑病患者的分流后压力应该更高。通过分流插管和荧光透视法对16例术后完全康复的患者测定门静脉压力和门静脉血流模式。在6至24个月（平均12个月）期间对患者进行门体性脑病筛查，此时记录分流通畅情况。有和没有门体性脑病的患者以及有和没有正向血流患者的门静脉压力相似。这些结果不支持门静脉压力是10毫米门腔H型分流术后门体性脑病发生率或血流模式的重要决定因素这一概念。
