摘要
目的 探讨以脐静脉-大隐静脉转流术治疗重度门脉高压、食管胃底静脉曲张大出血的临床应用.方法 对30例肝功能差或伴有心肺肾等重要器官功能不全的门脉高压、食管胃底静脉曲张破裂大出血病人,急诊经上腹白线切口暴露并游离脐静脉,游离适当长度的右侧大隐静脉.脐静脉血流已开放者,可直接将其与大隐静脉吻合;若未开放,用F3-5胆道探子将其重新打通,再与大隐静脉吻合,并对照吻合前后门静脉压力、血流速率及血流量.结果 30例手术均成功,术后近期效果良好.术前后门静脉最大血流速率和血流量分别为18.93±7.71cm/s、17.11±6.56cm/s和1686.37±816.32ml/min、1442.35±672.34ml/min;食管钡餐造影,23例食管曲张静脉消失,7例明显好转.结论 脐静脉-大隐静脉转流术具有微创、简便、疗效确实等优点,对于肝功能差、伴有心肺肾等重要器宫功能不全的患者尤为适用.
Objective: To explore the efficacy of umbilical vein to great saphenous venous shunt in the treatment of severe postal hypertension with hematemesis. Methods: 30 patients who had hematemesis and marked functional impairments of the heart or/and lung or/and kidney were treated with the above mentioned shunt as an emergency measure via linea alba to isolate umbilical vein, which was anastomosed to a reversed isolated righy saphenous vein through a subcutaneous tunnel. The pre- and post-operative portal pressure and maximal blood velocity and volume were examined.Results:Surgery was succeeded in all cases. After surgery, all patients were recovered and symptoms were relieved. Conclusion:Compared with classical porto-systemic decompressive operations, the umPilical vein-great saphenous venous shunt has advantages of mini-invasive, simplicity and substantial therapeutic effect. This procedure provides on more option to handle the emergent situation in portal hypertension.
出处
《中国现代普通外科进展》
CAS
1999年第4期42-43,共2页
Chinese Journal of Current Advances in General Surgery
