摘要
目的：探讨提高肝硬化门静脉高压症疗效的术式。方法：采用脾肾分流加联合断流术即脾切除，脾肾分流，胃底、贲门周围血管离断，食道下段离断吻合术治疗门脉高压症患者20例。术中连续监测自由门静脉压力（FPP）的动态变化。术后随访12例，随访时间6～30个月。结果：术后死亡1例，随访的12例患者无1例再出血及发生肝性脑病。术后2个月行食道钡餐检查，食道静脉曲张消失或基本消失10例，明显好转2例。11例术前有腹水，其中2例术前大量腹水，10例术后2个月左右腹水消失，1例术前大量腹水者术后6个月腹水基本消失。术后6个月内彩色多普勒检查9例，均显示门静脉向肝血流，脾肾吻合通畅，无血栓形成。结论：脾肾分流加联合断流术治疗门脉高压症既保留了分流术和断流术二者的优点，又克服了二者的缺点，而且联合断流术使断流更加彻底。
Objective: To explore a new operative method to improve the curative effects of portal hypertension caused by hepatocirrhosos. Method: 20 patients with portal hypertension were treated with combined devascularization (splenectomy, portaazygous devascularization and esophageal transection) and splenorenal shunt. Results: 1 patient died after operation. 12 patients were followed-up for 6～30 months postoperatively. None of the 12 patients had rebleeding and hepatic encephalopathy. Esophageal varices disappeared in 10 patients and improved in 2 patients. Ascites disappeared in 10 patients 2 months after operation, in 1 patient (with large amount) 6 months after operation. The bloodflow in portal vein and splenorenal anastomotic orifice were unobstructed under Color Doppler Sonography 6 months after operation. Conclusion: Combined devascularization and splenorenal shunt could make the devascularization more effectively in the treatment of portal hypertension.
出处
《江西医学院学报》
2001年第1期37-39,共3页
Acta Academiae Medicinae Jiangxi
关键词
脾肾分流术
断流术
门静脉高压症
应激性溃疡
hypertension,portal
splenectomy
splenorenal shunt,surgical
devascularization
