Yoshida T, Bandoh T, Kitano S, Shuto K, Ninomiya K, Mitarai Y, Kobayashi M
First Department of Surgery, Oita Medical University, Japan.
Surg Today. 1997;27(3):197-201. doi: 10.1007/BF00941644.
We measured the portal circulatory hemodynamic parameters in 10 cirrhotic patients with portal hypertension and esophageal varices to determine the significance of esophageal variceal pressure. In 4 patients (group I), the temporary portal vein occlusion produced significant elevations in both the esophageal variceal pressure and the portal venous pressure. The results of the portal circulatory hemodynamic assessment in this group were consistent with the predominance of the backward flow mechanism. In the remaining 6 patients (group II), however, portal vein clamping resulted in a slightly increased esophageal variceal pressure with an enormous increase in the portal pressure. The forward flow mechanism thus appeared to be predominant in group II. In other words, the results of the pressure measurements were consistent with the functional separation of the hemodynamics in the esophageal varices and portal trunk in group II and the functional hemodynamic continuity in group I. This functional separation between the esophageal varices and the portal trunk in group II might therefore have resulted from the increased blood flow in the lesser splanchnic region.
我们测量了10例患有门静脉高压和食管静脉曲张的肝硬化患者的门静脉循环血流动力学参数，以确定食管静脉曲张压力的意义。在4例患者（I组）中，临时门静脉闭塞导致食管静脉曲张压力和门静脉压力均显著升高。该组门静脉循环血流动力学评估结果与逆流机制占主导一致。然而，在其余6例患者（II组）中，门静脉夹闭导致食管静脉曲张压力略有升高，而门静脉压力大幅升高。因此，II组中顺流机制似乎占主导。换句话说，压力测量结果与II组食管静脉曲张和门静脉主干血流动力学的功能分离以及I组的功能血流动力学连续性一致。因此，II组食管静脉曲张和门静脉主干之间的这种功能分离可能是由于内脏小区域血流增加所致。
