自发性脾肾分流对门静脉高压性胃病的影响

Relationship between portal hypertensive gastropathy and existence of spontaneous spenorenal shunts

目的探讨自发性脾肾分流对门静脉高压性胃病的影响。方法对我院2000年3月￣2004年9月收治的门静脉高压症病人217例分别进行内镜和彩色多普勒检查,根据有无自发性脾肾分流将病人分成A、B两组,比较两门静脉高压性胃病的发生率和严重程度。结果具有自发性脾肾分流(A组)的患者为43人,无自发性脾肾分流(B组)的患者为174人,自发性脾肾分流的发生率为19.35%。A组门静脉高压性胃病的发生率为23.26%,B组的发生率为54.59%,A、B两组门静脉高压性胃病发生率差异的比较有显著性(P=0.000)。门静脉高压性胃病的轻重与有无自发性脾肾分流具有相关性(R=0.283,P=0.000)。结论自发性脾肾分流能降低门静脉高压性胃病的发生率并缓解其严重程度,在行脾切除术时注意保护自发性的脾肾分流。

Objective] To evaluate the relationship between the portal hypertensive gastropathy and the existence of spontaneous splenorenal shunts. [Methods] To compare the incidence rate and severity of the portal hypertensive gastropathy between the two groups; group A, 43 patients with portal hypertension and spontaneous splenorenal shunts; group B, 174 patients with portal hypertension and without spontaneous splenorenal shunts. [Results] The incidence rate of the portal hypertensive gastropathy in group A was 23.26%, and it was 54.59% in group B. There was significant difference in the incidence rate of the portal hypertensive gastropathy between group A and group B (P =0.000). The severity of the portal hypertensive gastropathy was related to the existence of spontaneuous splenorenal shunts ( R=0.0283, P =0.000). [Conclusions] The existence of spontaneous splenorenal shunts can decrease the incidence rate and relieve the severity of the portal hypertensive gastropathy. It will be necessary that the spontaneous splenorenal shunts should be presered when speen is resected.