摘要
为了对小儿肝前型门脉高压症不同的治疗方法进行评价，寻找比较合理的治疗方案，对本院２０年来收治的２７例小儿肝前型门脉高压症患儿的资料进行回顾性分析和随访。其中行断流术者１４例，分流术８例，单纯切脾和大网膜包肝包肾术５例。随访１６例，５例有再出血史。随年龄增长出血逐渐停止，全组无死亡。结论：小儿肝前型门脉高压症主要是由于门静脉主干或脾静脉梗阻、栓塞而致门静脉压力增高，而肝脏功能、结构均正常，预后好。自然侧支循环形成为本症最好的结果。因此提倡做能促进侧支循环建立的手术，如大网膜包肝包肾、脾肺固定术。断流术主要用于救治大出血者及反复多次出血者。分流术及脾切除的目的在于降低门脉系统压力避免静脉曲张，并能刺激自然侧支分流。所以分流术以远端分流较好，并只主张行巨脾切除。
A retrospective analysis was made on 27 cases of extrahepatic portal hypertension during last 20 years to evaluate the different conventional operation and look for a reasonable protocal of therapy. The operation performed on 27 cases included : cardio-gastrotransection (14), splenorenal shunting (8) , splenectomy and omentohepatopexy or omentorenopexy( 5 ) . Among the follow-up of l6 cases . 5 had recurrent bleedings. Most cases of prehepatic hypertension in children resulted from extrahepatic obstruction of portal or splenic flow with normal function and structure of the liver. The prognosis was good. The authors suggest that a reasonable cure be relied on the development of collateral circulations and decompressing high pressure portal flow to the systemic circulation. Cardiotransection is. only indicated in cases with recurrent bleeding. Limited porto- caval and removal of huge spleen are effective in decompressing the portal pressure and controlling hemorrhage from esophageal varies.
出处
《中华小儿外科杂志》
CSCD
1996年第5期264-266,共3页
Chinese Journal of Pediatric Surgery
关键词
门脉系统分流术
门脉高血压
肝循环
儿童
Portosystemic shunt , surgical
Hypertension , portal
Liver circulation
