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长期来人们相信门脉高压系窦前、窦内、或窦后门脉阻力增高所致,内脏静脉流入量一般无改变或有所下降,故充血门脉系的手术减压被认为是最持久有效的降压和治疗其并发症的方法.近20年来对本症的更新认识和一些新疗法的使用使人们改变了曲张静脉出血的处理.本症病理生理方面的主要进展是实验发现内脏血流量增加在维持门脉高压中起着重要作用,尽管门脉阻力增高仍是高压的始动因素.小鼠实验性门脉狭窄的早期反应是门脉充血和压力上升,几天后侧枝循环使90%以上门脉血得以分流,致心搏量增多、周围循环阻力下降、门脉流入量大增而使门脉继续维持高压.近期实验更显示这一血流动力学改变溯源于两个因素.一是体循环中具有血管扩张作用的高
For a long time people believe that portal hypertension is caused by anterior sinus, sinus, or posterior sinus venous resistance increases, visceral venous intrusion generally no change or decline, so congestion portal vein surgical decompression is considered the most lasting Effective antihypertensive and treatment of its complications.New awareness of the disease over the past 20 years and the use of some new therapies so that people have changed the treatment of varicose vein bleeding.The main pathophysiological progress of this disease is the experiment found that visceral blood flow Increases in the maintenance of portal hypertension plays an important role, although the portal resistance is still the starting factor of high pressure.The early experimental portal venous stenosis in mice is portal congestion and pressure rise, a few days after the collateral circulation 90 More than one percent of the portal blood flow to the shunt, resulting in increased stroke volume, decreased resistance around the circulation, portal influx and the portal vein to maintain high pressure.Recent experiments show that the hemodynamic changes traced back to two factors. First, there is a high degree of vasodilation in the systemic circulation