Assessment of the relation between hepatic venous pressure gradient with portal vascular resistance and recurrent esophageal variceal bleeding of liver cirrhosis.
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摘要: 对有食管静脉曲张 (EV)出血后 ,肝硬化并门静脉高压之患者 2 1例 ,测定肝静脉压梯度 (HVPG)为 (2 2 6± 0 34)kPa;继之对其中之 18例又测门静脉血管阻力 (PVR)为 (0 2 3± 0 0 6 )kPa·ml 1·min·kg。治疗分两组 :手术组(n =10 )和介入组 (n =11) ,前者其HVPG和PVR之两值显著低于后者 ,随访 18个月内再出血率 ,手术组 (30 % )显然低于介入组 (5 4 6 % ) ,但两组之再出血例如以两值中位数相对比则无差异 ,均发生于高值者。再出血例与未再出血例就两值相对比 ,前者显著高于后者 ,差异非常显著 ,PVR尤著 (P <0 0 0 1)。本研究提示HVPG >2 33kPa ,PVR >0 2 2kPa·ml 1·min·kg是EV再出血危险的域值。HVPG与PVR呈正相关。Abstract: After esophageal variceal bleeding (EVB) epsoide from Liver Cirrhosis in 21 patients, the hepatic venous pressure gradient (HVPG) 2 26±0 34kPa was measured, among of 18 cases with portal vascular resistance (PVR) 0 23±0 06kPa·ml 1 ·min·kg also calculated subsequently. According to therapy operating group (n=10) and interventional group (n=11) were divided, the both values (HVPG and PVR) of former was obviously lower than the latter, within 18 months follow-up for recurrent EVB (REVB) rate, the former (30%) was lower than the latter (54 6%) . While Comparison with median of both values of cases of REVB (from both groups) showed no difference, however, REVB all nearly ocurred in patients with those two higher values. As to both values of cases of REVB Compared with cases of non-rebleeding, it showed that the former was extremcly higher than the latter, the difference was signifant even more in the PVR ( P <0 001) . This study provided that the HVPG>2 33 kPa and PVR>0 22 kPa·ml 1 ·min·kg was risky threshold of REVB. The values of HVPG and PVR was possitive coefficient relation ( r =0 68)
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