分流术治疗小儿门静脉高压症

The shunt for portal hypertension in children

作者采用分流术治疗１０例小儿门静脉高压症。９例为肝外型，１例为肝内型。其中行脾肺固定、门肺分流术的３例，术后均无再出血。３例中２例Ｄｏｐｐｌｅｒ彩超、核素检查证实门肺分流已建立。６例行肠腔静脉分流术者，３例随访５～１４年未再出血，另３例效果欠佳，其中１例死于再出血。１例行脾肾静脉分流者年龄为１１岁，属肝内型，术后随访３年来未再出血。作者认为脾肺固定、门肺分流手术是一种较为安全而有效的术式。

AbstractTen children with portal hypertension were treat-ed with shunt operations. Among them,9 were ex-trahepatic and one was intrahepatic lesion. The follow-up for 1～14 years showed:( 1 )In the 3 patients treat-ed with splenopneumopexy, hemorrhage from theexophageal varices were controlied and portopulmonaryshunt was demonstrated by DUppler ultrasound andradionuclide;(2) In the 6 patients treated with meso-caval shunt,3 were non-recurrent bleeding and 2 diedof recurrent bleeding or other dlstase respectively;(3)In one child with hepatic cirrhosis(11 year old)treatedby splenorenal shunt,non-recurrent bleeding occured.The authors suggest the portopulmonary shunt bysplenopneumopexy is safe and effective for the portalhypertension of children