自体脾移植联合食管横断吻合术治疗肝硬化门静脉高压症210例分析

Spleen autotransplantation in retroperitoneum combined with lower esophagus transection in the treatment of hepatic cirrhosis induced portal hypertension: a study of 210 cases.

目的 研究腹膜后自体脾移植联合食管下段横断术治疗肝硬化门静脉高压症的临床效果。方法 1979～ 2 0 0 1年中山大学孙逸仙纪念医院收治肝硬化门静脉高压症病人 2 10例 ,观察腹膜后自体脾移植手术死亡率和并发症。结果 手术死亡 4例 (1 90 % ) ,术后并发膈下脓肿、成人呼吸窘迫综合征、肺炎等 4 5例 (2 1 4 3% ) ,肝性脑病 1例 (0 4 7% ) ,术后门静脉高压性胃炎出血 19例 (9 0 5 % ) ,术后肝癌发生率为 7 6 2 % (16例 )。结论 腹膜后自体脾移植术安全、可靠 ,疗效确切 ,值得临床上推广应用。

Objective To study the therapeutic effect of spleen autotransplantation in retroperitoneum combined with lower esophagus transection in the treatment for hepatic cirrhosis induced portal hypertension. Methods From 1997 to 2001,210 cases of portal hypertension were treated in the Sun Yat-sen memorial hospital. And the operative mortality and complication were observed. Results Four cases died in the operation. The postoperative complications including subphrenic abscess、 adult respiration depressed syndrome (ARDS)、pneumonia occurred in 45 cases (21.43%). Hepatic encephalopathy occurred in 1 case (0.47%). Postoperative portal hypertensive gastropathy hemorrhage(PHG) occurred in 19 cases(9.05%). The postoperative hepatic carcinoma was occurred in 16 cases (7.62%). Conclusion Spleen autotransplantation in retroperitoneum combined with lower esophagus transection is a safe and effective procedure.