脾肾分流加贲门周围血管离断术治疗门脉高压症──附8例报告

Therapy of portal hypertension by splenorenal shunt combined with pert-cardial devascularization ──report of & cases

从１９９１年９月～１９９２年４月共为８例病人进行了脾肾分流加贲门周围血管离断术，８例均为男性，年龄１８～４１ａ，平均３２．２ａ．本组８例肝功Ｃｈｉｌｄ分级均Ａ级，术前脉冲多普勒Ｂ超检查门静脉向肝血流量７４７～１３２０ｍｌ·ｍｉｎ－１．平均１０５０ｍｌ·ｍｉｎ－１．术中测ＦＰＰ为３．５～４．２ｋＰａ，平均３．８ｋＰａ．切脾后门静脉压为２．５～３．５ｋＰａ，平均２．９ｋＰａ，分流和断流后门静脉压２．５～３．５ｋＰａ．平均２．８ｋＰａ．全组病例随访２４～４２ｍｏｎ，８例均能参加正常工作．除１例有轻食道静脉曲张外，其余７例食道静脉曲张均消失，多普勒Ｂ超检查脾肾吻合口均通畅．

The splenorenal shunt combined with pert-cardial devascularization were performed in 8 patients since September 1991 to April 1992. All the patients were males, aged from 18 to 41 (average 32.2). The hepatic function were all A degreeaccording to Child classification criteria.Doppler examination before operation showed portal blood inflow to be 747 to1320 ml·min-1 (average 1050 ml· min-1 ).FPP were 3. 5～4. 2 kpa (average 3. 8 kpa)after laparotomy, 2. 5 ～ 3. 5 kpa (average 2. 9 kpa) after splenectomy and 2. 5～ 3. 5kpa (average 2. 8 kpa ) after splenorenal shunt.Follow-up time ranged from 24 to 42mon. All patients returned to normal work after operation. Nearly none had esophageal varicosis after operation except one patient with mild varicosis. Doppler examination showed that blood could flow pass though the anastomosis in all cases.