关键词: 肝硬化, 门静脉高压症, 脾动脉盗血综合征, 脾切除术, 贲门周围血管离断术, 血流动力学

Abstract: Objective To investigate the changes of hemodynamics after splenectomy combined with pericardial devascularization in patients with cirrhotic portal hypertention complicated by splenic artery steal syndrome. Methods 84 patients with cirrhotic portal hypertension and splenic arterial blood theft syndrome were admitted to our hospital between February 2015 and February 2017,and 42 received splenectomy combined with pericardial vascular devascularization,while another 42 received conventional supporting therapy. The portal vein flow （PVF）,portal vein diameter（PVD）,portal vein velocity （PVV）,spleen venous flow （SVF）,splenic vein diameter （SVD） and splenic venous velocity （SVV） were obtained by ultrasonography. Results At admission,there were no significantly differences as respect to the portal hemodynamic indexes between the two group （P>0.05）,while two weeks after the treatment,the PVD,PVF,PVV,SVD,SVF and SVV in patients receiving surgery were（1.3±0.3cm） cm,（786.2±85.1） ml,（49.6±6.7） cm/s,（1.3±0.2） cm,（310.1±49.3） ml and（26.5±8.2） cm,improved significantly as compared to（1.6±0.4） cm,（848.1±94.6） ml,（40.1±6.5） cm/s,（1.4±0.3） cm,（377.2±55.2） ml and （19.8±7.2） cm in the control,respectively（P<0.05）;the white blood cell and platelet counts in patients receiving surgery were （7.7±3.2）×10⁹/L and （252.1±69.3）×10⁹/L,much higher than （3.1±1.9）×10⁹/L and （47.2±7.4）×10⁹/L（P<0.05）,respectively,in the patients receiving conventional supporting treatment;The liver function tests in patients receiving surgery improved more efficiently. Conclusion Application of splenectomy combined with pericardial devascularization in dealing with cirrhotic portal hypertention complicated by splenic artery steal syndrome is efficacious,but the long-term effect should be investigated in the future.

Key words: Cirrhosis, Portal hypertention, Splenic artery steal syndrome, Splenectomy, Pericardial devascularization, Hemodynamics