门静脉高压症外科治疗的一些问题

Some Issues on Surgical Treatments of Portal Hypertension

对于门静脉高压症的外科治疗问题多多,争论不休,主要是因为至今人们对于肝硬化门静脉高压症的自然病程了解甚少,另外至今没有一个高质量的多中心、前瞻性、随机对照的比较不同治疗方法疗效的临床研究报告。门静脉高压症患者的预后取决于肝脏原发疾病的进展,现有的传统手术方式都不能显著改善存活率。人类最终战胜肝硬化门静脉高压症有赖于多种途径解决供体来源,使肝脏移植造福于更多的肝硬化门静脉高压症患者,同时加强基础研究,探索延缓甚至逆转肝硬化进程、预防和治愈肝脏原发疾病的有效治疗手段。加强围手术期综合治疗有利于改善门静脉高压症传统手术的疗效。

Because of little understanding about natural course of liver cirrhosis and portal hypertension and lacking of highly qualitative multi-central prospective randomized control trial on different treatment techniques, surgical treatments on portal hypertension remain controversial. The prognosis of the patients with portal hypertension depends on the progression of primary liver disease, so the present traditional surgical operations could not obviously increase the survival rate. The final method for human being beating the disease relies on various ways to deal with donor sources, so that more patients with portal hypertension would benefit from liver transplantation. Furthermore, the basic research, including exploring the effective methods to postpone or reverse the liver cirrhosis and prevent and cure the primary liver disease, should be emphasized. Presently, to enhance the comprehensive perioperative managements would improve the outcomes of traditional operations on portal hypertension.