| Objective: To investigate the relationship of cirrhosis portal hypertension with hepaticartery and splenic arterial blood flow mechanics to provide a basis for exploring newmethods of diagnosis and treatment of liver cirrhosis portal hypertension associated withhypersplenism patients; To observe patients with liver cirrhosis portal hypertensionassociated with hypersplenism in partial splenic artery embolization (PSE) preoperativeand postoperative hemodynamics changes of the hepatic artery, splenic artery and portalvenous system, exploring the effect of PSE on portal hypertension control.Method: Forty-two patients with liver cirrhosis portal hypertension associated withhypersplenism of PSE treatment, utilizing color doppler ultrasound (CDU) to test bloodflow mechanics indexes of hepatic artery, splenic artery, splenic vein and portal vein inPSE preoperative and postoperative for one week, including the hepatic artery, splenicartery, splenic vein and portal vein the main detection indicators were blood vesseldiameter, blood velocity, blood flow volume and vascular resistance. Another eighty-eightcases of healthy controls were selected, also using color doppler ultrasonic to detect theblood flow mechanics corresponding indicators of hepatic artery, splenic artery, splenicvein and portal vein. Observation and comparison of liver cirrhosis patients with portalhypertension associated with hypersplenism of PSE preoperative and postoperative for oneweek,and noting the changes of hemodynamic indexs of epatic artery, splenic artery andportal vein, analysis of PSE’s impact on portal venous blood flow.Results: The group of patients with portal hypertension associated with hypersplenism inPSE preoperative the inner diameter of splenic artery, splenic vein and portal veinrespectively was (5.18±0.85) mm、(10.61±2.16) mm、(14.21±1.74) mm, the average bloodflow velocity respectively was (54.96±12.86) cm/s、(19.14±6.33) cm/s、(17.31±4.65) cm/s,the average blood flow volume respectively was (708.29±286.10) ml/min,(1156.4±82.56) ml/min,(1642.40±57.88) ml/min; Control group splenic artery, splenic vein and portalvein diameter respectively was（3.56±0.44）mm、（6.00±0.60）mm、（10.60±0.97mm）,the average blood flow velocity respectively was（37.43±13.14）cm/s、（18.01±3.42）cm/s、（17.91±3.51）cm/s, the average blood flow volume respectively was （231.65±114.21）ml/min、（308.34±82.12）ml/min、（959.97±261.23）ml/min. Comparison of the aboveindexes of the two groups, P <0.05, the difference was statistically significant, the group ofportal hypertension associted with hypersplenism observation indexes were higher than thecontrol group preoperative hepatic arterial blood flow volume（111.52±48.06）ml/minwere less than the control group（232.85±109.66）ml/ml/min, P <0.05, the difference wasstatistically significant; partial splenic artery embolization after one week, the estimatedvalue of each index respectively：hepatic blood flow volume was（382.57±314.53）ml/min,splenic arterial blood flow volume wa（s486.56±135.68）ml/min, splenic venous blood flowvolume was (1026.62±43.59) ml/min, portal venous flow volume was(1376.45±44.17)ml/min,compared with preoperative hepatic blood flow the volume increased, comparedwith preoperative indexes, the remaining indexes decreased, P<0.05, the difference wasstatistically significant.Conclusion: Patients with liver cirrhosis portal hypertension in splenic artery, splenicvein vascular diameter enlargement, circulating volume increase, which is the power factorof Portal hypertension formation blood flow injection, splenic embolization can reduce thespleen blood circulation volume, consequently, reduce portal vein pressure, and increasethe blood supply of the liver artery at the same time. |
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