彩色多普勒超声监测猪脑死亡状态下肝脏早期血流动力学变化的初步研究

发布时间：2018-04-03 23:50

本文选题：彩色多普勒超声　切入点：脑死亡模型　出处：《中国超声医学杂志》2017年02期

【摘要】：目的探讨多普勒超声技术(CDFI)监测猪脑死亡状态下,肝脏早期血流动力学变化及其相关因素。方法巴马香猪12头,应用改进缓慢间断颅内加压法建立脑死亡模型,通过呼吸、循环支持维持脑死亡状态12h。脑死亡前为对照组,脑死亡后为实验组,于脑死亡前、死亡0、3、6、9h监测血压、心率及肝脏血流参数:门静脉流速(PV)、血流量(PVF)、肝动脉收缩期流速(S)、舒张期流速(D)、肝动脉阻力指数(RI)、肝动脉S/D值、肝动脉搏动指数(PI)、肝静脉流速(V)。比较各组间差异及与血压、心率的相关性。结果 (1)脑死亡各组收缩压及舒张压均较对照组降低,脑死亡9h组收缩压与0h组相比降低,均有显著性差异(P0.05)。(2)脑死亡3、6h组PV较对照组降低,脑死亡各组RI、S/D及PI较对照组升高,均有显著性差异(P0.05);脑死亡组内各时间点血流动力学参数间差异无统计学意义(P0.05)。(3)收缩压与PV呈正相关(P0.05)。结论脑死亡状态下,机体早期表现为持续低血压;早期肝脏血流动力学即有明显变化,低血压所致低灌注导致门脉流速减低较为显著,肝动脉流速及相关阻力参数增高,肝动脉的相关阻力参数对肝脏早期病生理的改变较肝动脉流速更为灵敏。
[Abstract]:Objective to investigate the changes of liver hemodynamics and its related factors in the early stage of porcine brain death by Doppler ultrasound (CDFI).Methods 12 Bama pigs were used to establish the brain death model by modified slow intermittent intracranial compression. The brain death was maintained by respiration and circulatory support for 12 hours.The control group was used as the control group before brain death and the experimental group after brain death. The blood pressure was monitored for 6 hours before brain death.Heart rate and hepatic blood flow parameters: portal vein flow velocity (PVN), blood flow volume (PVF), hepatic artery systolic velocity (SBV), diastolic velocity (D), hepatic artery resistance index (RI), hepatic artery S / D (S / D), hepatic artery pulsatility index (Pi), hepatic vein velocity (VV).To compare the difference between each group and the correlation with blood pressure and heart rate.There was no significant difference in hemodynamic parameters between brain death group (P 0.05) and systolic blood pressure (SBP) was positively correlated with PV (P 0.05).Conclusion under the condition of brain death, the body presents persistent hypotension in the early stage, the hepatic hemodynamics changes obviously in the early stage, the portal velocity decreases significantly due to hypotension, and the hepatic artery velocity and related resistance parameters increase.The relative resistance parameters of hepatic artery were more sensitive to the physiological changes of early liver disease than to the flow velocity of hepatic artery.
【作者单位】：天津市第一中心医院超声科;
【基金】：天津市卫生局科技基金(No.13KG102) 天津市自然科技基金(No.15JCYBJC27000)
【分类号】：R445.1;R741

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