腔内外联合断流术对门奇静脉侧支循环影响的研究

The effects of combination of EVL and Hassab’s procedure on portoazygous collateral shunt in patients with portal hypertension

目的研究腔内外联合断流术对门奇静脉侧支循环的影响。方法2001年3月至2004年5月对腔内外联合断流术治疗43例的门静脉高压食管静脉曲张病人,运用微探头超声检查治疗前后食管下段静脉结构的情况,并进行对比研究。结果治疗后病人食管黏膜下曲张静脉消失,食管周围静脉丛曲张程度也明显减轻或消失。短期追踪随访静脉曲张的再发率和出血率分别为2.5%和0。奇静脉内径较治疗前有所变小,血流速度无明显改变,血流量较前下降43%。结论腔内外联合断流能有效地闭塞食管下段壁内外的静脉,阻断门奇静脉分流,防治食管静脉曲张出血与复发,而且操作简便,值得推广应用。

Objective To explore the efficacy and prognosis of combination of EVL and Hassab＇ s procedure treatment on portoazygous collateral shunt in patients with portal hypertension. Methods Fourty-three patients with esophageal varication were received a combination of EVL and Hassab＇ s procedure treatment for variceal eradication. The esophagus vascular structures were examined with endoscopy and miniature ultrasonic probe. The change of vascular structure was evaluated ,and recurcence and rebleeding of esophageal varices were also investigated. Results After treatment, the esoph- ageal varication was obliterated, and the collateral veins were diminished in size or obliterated, and the azygos blood flow （ABF） decreased 43%. During a short-term follow-up, the recurcence and rebleeding rate of esophageal varices were 2.5% and 0. Conclusion The combination of EVL and Hassab＇ s procedure can effectively shut off the portoazygous shunt,prevent esophageal varices bleeding. It＇s a simply and less cost procedure.