摘要
目的探讨一种新手术方法,即脾大部切除脾肾静脉人造血管架桥术治疗门静脉高压症的治疗效果。方法脾大部切除后以人造血管行脾肾静脉架桥术9例。先行保留脾上段的脾大部切除术,再行脾肾静脉人造血管架桥,最后行贲门周围血管离断。结果 1例术后2天因肝功能衰竭、创面渗血不止死亡,其余无脾断面出血、感染。无近期出血。本组病例获随访1～3年,无复发出血,经血液学(IgG、IgM、IgA)、B 超、CT、^(99m)锝扫描等证实:脾脏不同程度缩小,脾功能亢进缓解,残脾有免疫功能。Doppler彩色超声显像:人造血管血流通畅,无逆流现象。结论该术式既可解决门静脉高压症脾功能亢进问题,又能起到降压效果。
Objective To evaluate the effect of a novel therapy of subtotal splenectomy plus splerenal shunt in the treatment of portal hypertension.Method We carried out subtotal splenectomy plus splenorenal venous shunt by artificial vascular graft to treat patients with portal hypertension(PH).Since 1992.9 cirrhotic patients suffer- ing from esophageal varices and gastrointestinal bleeding underwent our newly designed procedures:subtotal splenectomy with its upper part conserved plus splenorenal venous shunt by artificial vascular graft and gas- troeophageal devascularization.Results Patients were followed up for 1～3 years,there was no postoperative recurrent bleeding or infection,one case died of hepatic failure.Hemological examination,B type ultrasound,CT and ^(99m)Tc scanning showed that spleens lessened in different extent along with hypersplenism relieved and im- munological function of residual spleen remained.Patent artificial vessels with no reflux showed by Doppler ul- trasound.Conclusion It was concluded that this approach seems to be an accessible way to achieve the solu- tion to hypersplenism and decompression of PH.
出处
《中华普通外科杂志》
CSCD
1998年第2期83-85,共3页
Chinese Journal of General Surgery
关键词
门静脉高血压
脾切除术
脾肾分流术
人工血管
Hypertension,portal
Splenectomy
Shunt,splenorenal
Blood vessel prosthesis
