摘要
目的 评价贲门周围血管离断术 (pericardial devasuclarization,PCDV )联合附加限制环的门腔分流术 (limitedside- to- side portacaval shunt,PCS- SS)治疗门静脉高压症的效果。方法 总结我院 1996年 4月至 2 0 0 1年 7月采用 PCDV联合 PCS- SS(放限制环 )治疗 13例门静脉高压症的经验。结果 择期手术 10例 ,预防性手术 3例 ,均无手术死亡。术前自由门静脉压力 (free portal pressure,FPP)平均为 (3.6 8± 0 .16 ) k Pa,术后为 (3.18± 0 .11) k Pa (P<0 .0 5 )。术前门静脉平均流速为(15 .2 5± 4 .18) cm / s,术后为 (14 .33± 3.75 ) cm / s。术前门静脉平均流量为 (16 2 5 .4 2± 384 .5 0 ) m l/ min,术后平均为 (10 86 .11±2 5 5 .5 1) m l/ min (P<0 .0 5 )。出院病例均随访至今 ,无手术后再出血 ,发生肝性脑病 2例。结论 该联合手术具有断流和合理口径分流的特点 ,手术简单可行 。
Objective To evaluate the effect of combined PCDV and limited side to side portacaval shunt with the addition of restrictive ring for the treatment of portal hypertension.Methods The data from 13 cases with portal hypertension treated by PCDV and restrictively side to side portacaval shunt with the addition of restrictive ring from April 1996 to June 2001 was summarized. Results There was no mortality and short term rebleeding in all cases; 10 cases underwent selective operation and 3 cases received preventive operation. The free portal pressure before and after operation was 3.68±0.16 kPa and 3.18±0.11 kPa,respectively( P <0.05). Both portal flow velocity and portal flow decreased significantly postoperatively (15.25±4.18 vs 14.33±3.75cm/s;( P <0.05)and 1625.42±3840.30 vs 1086.11±255.51ml/min P <0.05.All patients have been followed up. There was no recurrence of esophageal variceal bleeding. Two patients had encephalopathy. Conclusion Combined PCDV and restrictively portacaval shunt with the addition of restrictive ring is characterized by complete devascularization of sustaining varices and restrictively portacaval shunt with reasonable diameter. The combined procedure is a rational and practical procedure for the treatment of patients with portal hypertension..
出处
《肝胆外科杂志》
2003年第5期354-356,共3页
Journal of Hepatobiliary Surgery
