Burchell A R, Moreno A H, Panke W F, Nealon T F
Ann Surg. 1976 Sep;184(3):289-302. doi: 10.1097/00000658-197609000-00006.
We have documented a highly significant increment in hepatic arterial flow following a portacaval shunt in patients with cirrhosis of the liver and portal hypertension. In contrast with other hemodynamic variables, the increment in arterial flow was directly related to morbidity, hospital mortality, and long term survival. Patients with increments smaller than 100 ml/min had the worst clinical results. They accounted for all of the hospital mortality, the largest incidence of encephalopathy, and the worst long term cumulative survival rates. The extent of the increment was not related directly to the type of shunt but, rather, to some intrinsic capability of the cirrhotic liver to increase its arterial flow in response to the relief of sinusoidal hypertension produced by the shunt. This capablilty appears related to the degree of entrapment of the hepatic arterioles by the fibrous tissues of cirrhosis. This encasement of arterioles should change the elastic properties of the hepatic arterial bed and we propose to measure these properties by determining the characteristic input impedance of the arterial bed.
我们已经记录到，在患有肝硬化和门静脉高压症的患者中，门腔分流术后肝动脉血流量有显著增加。与其他血流动力学变量不同，动脉血流量的增加与发病率、医院死亡率和长期生存率直接相关。动脉血流量增加小于100毫升/分钟的患者临床结果最差。他们占了所有医院死亡率、脑病发生率最高以及长期累积生存率最差的情况。血流量增加的程度与分流类型没有直接关系，而是与肝硬化肝脏响应分流所产生的窦状隙高血压缓解而增加其动脉血流量的某些内在能力有关。这种能力似乎与肝硬化纤维组织对肝小动脉的包绕程度有关。小动脉的这种包绕会改变肝动脉床的弹性特性，我们建议通过测定动脉床的特征输入阻抗来测量这些特性。
