远端脾肾分流加胰脾断流术加断流术后肝外门静脉血流动力学的变化
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吕振祺

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Hemodynamic changes in the extrahepatic portal vein after combined distal splenorenal shunt, splenopancreatic disconnection and gastric disconnection
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    目的:探讨远端脾肾分流加胰脾断流术(DSRS +SPD)后和在此基础上加断流术后肝外门静脉血流动力学的变化。方法:插管分别连续测量犬的术前、DSRS+SPD术后、加断流术后自由门静脉压、脏侧闭塞压及平均动脉压,并计算肝外门体分流率。结果:DSRS+SPD术后,自由门静脉压下降(0.07±2.41)mmHg(P>0.05),脏侧闭塞压下降(19.10±10.45)mmHg (P<0.01),平均动脉压下降(31.35±22.18)mmHg(P<0.01),门体分流率增加(4.53±4.09)% (P<0.01)。加断流术后,自由门静脉压下降(1.82±1.38)mmHg (P>0.05),脏侧闭塞压增加(11.14±8.85)mmHg (P<0.01),平均动脉压下降(9.83±7.59)mmHg (P>0.05),门体分流率下降(6.72±4.55)%(P<0.01)。结论:在门静脉系统的肠系膜区与胃脾区两个功能区之间存在功能屏障,DSRS+SPD加断流术可增强这一屏障。

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    Abstract:Objective:To study the extrahepatic hemodynamic changes in portal system after DSRS+SPD and after DSRS+SPD+Disconnection in dogs. Methods:The FPP, POPP and MAP levels before operation, after DSRS+SPD and DSRS+SPD disconnection operation were measured; and the portal-system shunt(PSS) was calculated postoperatively. Results:After DSRS+SPD, FPP decreased(0.07±2.41)mmHg(P>0.05),POPP decreased(19.10±10.45)mmHg(P<0.01), MAP decreased (31.35±22.18)mmHg (P<0.01),PSS increased (4.53±4.09)% (P<0.01). After DSRS+SPD+Disconnection,FPP decreased (1.82±1.38)mmHg (P>0.05),POPP increased (11.14±8.85)mmHg (P<0.01), MAP decreased(9.83±7.59)mmHg (P>0.05),PSS decreased (6.72±4.55)% (P<0.01). Conclusions:There are two systems in the portal system, namely, gastrosplenic (GS) system and portomesenteric (PM) system, and between the two systems there is a functional barrier. DSRS+SPD+Disconnection operation can strengthen this barrier.

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吕振祺,金洪永,张学文,郑泽霖.远端脾肾分流加胰脾断流术加断流术后肝外门静脉血流动力学的变化[J].中国普通外科杂志,2006,15(12):4-892.
DOI:10.7659/j. issn.1005-6947.2006.12.004

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  • 在线发布日期: 2006-12-25