摘要
目的 评价以脾肾分流术为主的联合手术治疗小儿门静脉高压症的效果。 方法 对1980～ 1998年 2 2例小儿门静脉高压症患儿的手术结果及随访资料进行分析。本组男 13例、女 9例。平均年龄 9 45岁。肝内型 16例、肝前型 6例。肝功能属ChildA级 14例、B级 7例、C级 1例。均行联合手术。 结果 无手术死亡病例。 2 1例 (95 5 % )获访。随访最长时间 19年 ,平均 9 5 8年。术后再出血 6例 ,死亡 2例。 <3、～ 5、～ 10、～ 15、>15年生存率分别为 95 2 %、10 0 %、93 8%、10 0 %、10 0 %。生存病例生活质量好 ,无肝性脑病发生。 结论 以脾肾静脉分流术为主 ,加贲门周围血管离断术和大网膜腹膜后固定术是防治小儿门静脉高压出血的首选术式。对术后再出血的治疗应采取积极的态度。
Objective[WT5”BZ] To assess the effect of combined operation including splenorenal shunt as the main technique for portal hypertension in children. [WT5”HZ]Methods[WT5”BZ] 22 patients were reviewed and followed up from 1980 to 1998 (13 male, 9 female). The average age was 9 45 years. Intrahepatic type was shown in 16 patients and prehepatic type in 6. All patients had hematemesis, melina or severe esophageal varices. Liver function was classified Child A in 14 patients, B in 7, and C in 1. Combined operation was performed in all patients. [WT5”HZ]Results[WT5”BZ] There was no operative death in this group.21 patients (95 5%)were followed up, with the longest time for 19 years (average 9 58 years). Six patients had hemorrhage from the esophageal varices after operation, and two died of hemorrhage.The suvival rates of <3,-5,-10,-15,>15years were 95 2%,100%,93 8%,100%,100% respectively. No hepatocephalopathy was noted. [WT5”HZ]Conclusion[WT5”BZ] In treating and preventing hemorrhage from the esophageal varcies, combined operation induding splenorenal shunt as the main technique is the first choice for the portal hypertension in children. Attention must be paid to the patients who had hemorrhage from the esophageal varices after operation.[WT5”HZ]
出处
《中华外科杂志》
CSCD
北大核心
2000年第8期601-603,共3页
Chinese Journal of Surgery
关键词
脾肾分流术
联合手术
儿童
门脉高压症
Hypertension
portal
Splenorenalshunt
surgery
Esophageal and gastric varices
