Doppler ultrasonographic evaluation of hepatic circulation in patients following kasai's operation for biliary atresia
Doppler ultrasonographic evaluation of hepatic circulation in patients following kasai's operation for biliary atresia
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多普勒超声对葛西氏胆道闭锁术后患者肝循环的评价
DOI：
10.1007/bf00311686
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发表时间：
1995
期刊：
影响因子：
2.5
通讯作者：
S. Nosaka
中科院分区：
文献类型：
--
作者：
M. Nakada;Koonosuke Nakada;T. Fujioka;F. Kawaguchi;N. Yamate;S. Nosaka
应用多普勒超声对8例胆道闭锁加塞手术患儿的肝循环进行了动态观察。共行36次检查，测量门静脉主干（MPV）、脾静脉（SV）和肝动脉（HA）的最大血流速度（mvs），分析频谱波形和血流方向。4例患者的平均mvs-MPV为19.8±7.5 cm/s，其中4例患者已实现充分的胆管分流，血清胆红素已降至正常范围内（A组）。其MPV波形恒定，血液流向肝脏，而其平均mvs-SV为12.1±5.8 cm/s。在另外两名明显脾功能亢进但血清胆红素水平已降至接近正常的患者（B组）中，平均mvs-MPV为20.7±10.4 cm/s，mvs-SV为22.4±10.4 cm/s。相比之下，其余2例患者（C组）的mvs-MPV为14.2±9.1 cm/s，这些患者的血清胆红素水平未降至正常范围内，或最初下降但由于复发性胆管炎而升高。这些患者的波形不稳定，MPV血流偶尔为离肝血流，平均mvs-SV为18.0±5.8 cm/s。mvs-HA在后4例患者中显著增加，其临床状况也恶化。这些观察结果得出的结论是，肝循环评价系列多普勒超声提供了重要的信息，肝脏状态的儿童谁经历了加塞手术的胆道闭锁。
The hepatic circulation of eight children who underwent Kasai's operation for biliary atresia was serially evaluated by Doppler ultrasonography (US). A total of 36 examinations were performed to evaluate the maximal velocities (mvs) of the main portal vein (MPV), splenic vein (SV), and hepatic artery (HA), and to analyze the spectral waveform and the directions of flow. The mean mvs-MPV in four patients for whom adequate biliary diversion had been achieved and whose serum bilirubin had fallen to within the normal range (group A), was 19.8±7.5 cm/s. Their MPV waveforms were constant, with blood flowing toward the liver, while their mean mvs-SV was 12.1±5.8 cm/s. In two other patients with apparent hypersplenism, but whose serum bilirubin levels had fallen to nearly normal (group B), the mean mvs-MPV was 20.7±10.4 cm/s and the mvs-SV was 22.4±10.4 cm/s. In contrast, the mvs-MPV in the two remaining patients, whose serum bilirubin levels had either not fallen to within the normal range, or had fallen initially but increased due to recurrent cholangitis (group C), was 14.2±9.1 cm/s. In these patients, the waveforms were unstable, the MPV flows were occasionally hepatofugal, and their mean mvs-SV was 18.0±5.8 cm/s. The mvs-HA were markedly increased in the latter four patients, whose clinical condition had also deteriorated. These observations led to the conclusion that hepatic circulation evaluated by serial Doppler US provides important information about liver status in children who have undergone Kasai's operation for biliary atresia.