摘要
目的探讨系-腔 C 形、H 形架桥术对门脉高压症再出血的临床疗效及肠系膜上静脉外科干解剖变异时的临床处理。方法总结2002年1月至2004年8月36例门脉高压症术后再出血病例资料,其中脾切除、断流术后再出血21例,近端脾肾分流术后再出血9例,远端脾肾分流术后再出血4例,近端脾肾分流术+断流术后2例;再出血后行系-腔 C 形架桥术18例,系-腔 H 形架桥术12例,肠系膜上静脉外科干解剖变异改行肠系膜下静脉-下腔静脉分流术4例,改行冠腔分流术2例。通过术中测压、术后 B 超测定吻合口血流量以及胃镜、肝功能随访评价系-腔分流术临床疗效。结果术后门脉降压明显,随访6个月至3年,吻合口通畅,胃底静脉曲张减轻,无一例再出血,无严重并发症,无一例死亡。结论系-腔分流术能有效的治疗门脉高压症术后再出血,其中 C 形架桥术降压效果最明显;当肠系膜上静脉外科干解剖变异时,应及时选择其它分流方法。
Objective To investigate the efficacy of superior mesenteric vein-inferior vena cava shunt and dissection of surgical shaf of superior mesenteric vein in treatment of postoperative recurrent bleeding in portal hypertension. The clinical data of 36 portal hypertensive patients with postoperative recurrent bleeding treated in our hospital from January 2002 to August 2004 were retrospectively analyzed. Of the 36 patients, 18 received superior mesenteric vein-inferior vena cava C shunt, 12 superior mesenteric vein-inferior vena cava H shunt,4 inferior rnesenteric vein-inferior vena cava shunt and 2 coronary vein-inferior vena cava shunt. Follow-up endoscopy was performed every 6 rnonths. The operative mortality, morbidity, variceal status, blood flow of stoma and causes for recurrent bleeding were evaluated. Results All the 36 patients had the follow-up survey data. The stoma was unobstructed and gastroesophageal varices relieved. The postoperative mortality was 0%. There was no patients with bleeding or severe complications. Conclusions Superior mesenteric vein-inferior vena cava shunt is effective to control and prevent postoperative recurrent bleeding in patients with portal hypertension.
出处
《中华肝胆外科杂志》
CAS
CSCD
2006年第4期233-234,共2页
Chinese Journal of Hepatobiliary Surgery
关键词
高血压
门静脉
再出血
外科治疗
Hypertension, portal
Recurrent bleeding
Surgical treatment
