摘要
目的 研究直接门静脉造影在门静脉高压症治疗中的作用。方法 采用直接门静脉造影观察 185例门静脉高压症患者侧支血管和冠状静脉解剖 ,根据造影结果对 35例门静脉高压症患者行经腹联合门奇断流术。结果 门静脉高压症患者显示冠状静脉 2 2 3支 ,其中单支 79.46 % ,双支 2 0 .5 4% ,冠状静脉开口于门静脉主干、脾静脉和门脾静脉交汇处分别为 6 2 .33%、2 7.35 %和 8.0 7% ,出血和断流术后现出血患者主要位于门静脉主干 ,顽固性腹水无出血者多数位于脾静脉 ;显示脐静脉曲张 2 0例 ,脾胃静脉曲张 4例 ,肠系膜静脉曲张 2例。断流术后造影显示冠状静脉和食管曲张静脉完全消失 ,钡餐复查示食管静脉曲张消失或显著减轻。结论 直接门静脉造影不仅了解门静脉侧支血管 ,而且对门静脉高压症的治疗有重要的指导作用。
Objective To study the clinical significance of direct portography for patients with portal hypertension.Methods the portosystemic collateral pathways and the anatomic variations of coronary veins were observed with direct portography in 185 patients with cirrhotic portal hypertension.Results 223 branches of coronary vein are observed in 185 patients with cirrhotic portal hypertension by direct portography.Of thich single branch and two branches are observed in 79.46% and 20.54% respectively.The sites of coronary vein arising from portal vein,splenic vein or junction of portal and splenic vein were found in 62.33%,27.35% or 8.07% respectively.The confluence of coronary vein and portal vein was found in most of patients with variceal bleeding and recurrent bleeding after devascularization procedure.The confluence of coronary vein and splenic vein was observed in most of refractory ascites without variceal bleeding.Umbulical varices,gastric and perisplenic varices,and mesenteric varices were demonstrated in 20,4 and 2 patients with portal hypertension.Conclnsion Direct portography not only observe the portosystemic collateral pathways,but also guide to treat portal hypertension.
出处
《肝胆外科杂志》
2000年第1期14-16,共3页
Journal of Hepatobiliary Surgery
