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目的探讨胆总管囊肿肝脏血液动力学变化的意义。方法彩色多普勒血流显像（ＣＤＦＩ）监测２２例胆总管囊肿患儿手术前后肝脏血液动力学变化，并取肝活检观察组织学及血管形态学改变。结果肝病变主要在汇管区，炎性细胞浸润、小胆管及纤维组织增生，门脉分支受压而小动脉数目增多，据此将肝病变分为Ⅰ、Ⅱ和血型；门脉截面积手术前后无明显变化（Ｐ＞０．０５），肝动脉术前较术后扩张（Ｐ＜０．０１）。ＣＤＦＩ监测门脉流速、血流量和肝动脉阻力指数Ⅰ型肝病变手术前后无改变；Ⅱ、Ⅲ型术前明显降低（Ｐ＜０．０１），术后Ⅱ型基本恢复正常，Ⅲ型有所增加。结论肝脏血流参数随其病变程度加重而下降；肝脏病损主要系胆道梗阻所致，在一定程度上可逆；ＣＤＦＩ可用于判断肝脏病损情况。
Objective To investigate the significance of hepatic hemodynamic changes in common bile duct cysts. Methods Color Doppler flow imaging (CDFI) was used to monitor the changes of hepatic hemodynamics in 22 children with choledochal cyst before and after operation. Histological and morphological changes were observed by biopsy. Results The liver lesions were mainly in the portal area, inflammatory cell infiltration, small bile duct and fibrous tissue hyperplasia, portal vein pressure and the number of arterioles increased, liver disease was divided into Ⅰ, Ⅱ and blood type; portal vein cross-sectional area before and after surgery No significant changes (P> 0.05), hepatic artery preoperative than postoperative dilation (P <0.01). The changes of portal vein velocity, blood flow and hepatic artery resistance index of CDFI in type Ⅰ hepatopathy were not changed before and after operation. The levels of type Ⅱ and Ⅲ before operation were significantly lower than those before operation (P <0.01) increase. Conclusions The parameters of hepatic blood flow decline with the severity of the lesion. The liver lesion is mainly caused by biliary obstruction and is reversible to a certain degree. CDFI can be used to judge the lesion of the liver.