摘要
目的 探讨脾静脉 下腔静脉人工血管架桥术 (简称脾 腔人工血管架桥术 )在布 加综合征 (B CS)治疗中的应用价值。方法 对 1999～ 2 0 0 2年郑州大学第一附属医院 72例B CS病人 (均为Ⅱ型 )的临床资料进行对比研究 ,其中脾 腔人工血管架桥术 2 6例 ,肠系膜上静脉 下腔静脉人工血管架桥术 (简称肠 腔人工血管架桥术 )4 6例。结果 脾 腔人工血管架桥术组 (简称脾 腔组 )手术后血小板数明显升高 (P <0 0 5 )。分流前后自由门静脉压力 (freeportalpressure ,FPP)变化情况 :脾 腔组和肠 腔人工血管架桥术组 (简称肠 腔组 )均下降 (P <0 0 5 ) ,但两组之间手术前后FPP差异无显著意义 (P >0 0 5 )。两组均无围手术期死亡。对 2 0例脾 腔组和 36例肠 腔组B CS病人进行了 6个月至 3 5年的随访 ,有效率分别为 90 0 %、91 7% ,肝性脑病发生率分别为 5 0 %、5 6 % ,均未发生再出血。结论 脾 腔人工血管架桥术治疗B CS ,可有效降低门静脉压力 ,控制上消化道出血 ,达到了肠 腔架桥术同样的效果 ,且可消除病人脾功能亢进。
Objective To explore the application value of splenocaval shunt with artificial vascular graft in the treatment for Budd-Chiari syndrome(B-CS). Methods The clinical data of 72 B-CS patients were compared(all were type Ⅱ patients)including 26 cases of splenocaval shunt(splenocaval group)and 46 cases of mesocaval C-shape shunt(mesocaval group)admitted from 1999 to 2002 to First Affiliated Hospital of Zhengzhou University. Results In splenocaval group, the platelet of all patients got a significant increase after the operation(P<0.05). Both groups got a significant decrease of free portal pressure(FPP)(P<0.05)comparing with pre- and postoperatively. But there were no significance compared between the two groups(P>0.05). No patient died at perioperation in the two groups. Twenty cases in splenocaval group and 36 cases in mesocaval group were followed up from 6 months to 3.5 years. The effective rates were 90.0% and 91.7%. The occurrence of hepatic encephalopathy in the two group were 5.0% and 5.6% and no hemorrhage recurred. Conclusion Splenocaval shunt is used in the treatment for B-CS, which can decrease FPP effectively, control upper gastrointestinal hemorrhage and eradicate the hypersplenism. This method can get the same results as mesocaval shunt does.
出处
《中国实用外科杂志》
CSCD
北大核心
2004年第12期724-726,共3页
Chinese Journal of Practical Surgery
