摘要
目的 探讨脾静脉与大隐静脉吻合术治疗门静脉高压的作用。方法 1994 年3 月~1998 年3 月共采用脾静脉大隐静脉吻合术治疗门脉高压症12 例,男7 例,女5 例,年龄34 ±6.35 岁(26 ~54 岁) 。常规脾切除,游离脾静脉及一定长度的大隐静脉,将大隐静脉经皮下隧道进入脾床,与脾静脉吻合。术中测定吻合前、后门静脉压力。术前及术后1 个月用彩色多普勒超声系统测定门静脉血流量、血流速率。结果 吻合前、后平均门静脉压力分别为29.38 ±2.75 ,24.68 ±2.55 cmH2O( P < 0 .01 ) 。术前门静脉最大血流速率19.86 ±8.65 cm/s,术后降至16.27 ±7.54 cm/s ,下降18.93 % ( P < 0 .01 ) ;术前门静脉最大血流量1706.32 ±814.27 ml/min ,术后降至1 323.02 ±630 .52 ml/min ,下降22.46 % ( P < 0 .01 ) 。食管钡餐检查静脉曲张消失者8 例,明显减轻3 例,无变化1 例。随访1 ~4 年无再出血,无肝性脑病及死亡病例。结论 脾静脉大隐静脉吻合术可有效地降低门静脉压力,且无肝性脑病发生,简便易行。
Objective To study the effect of splino great saphenous venous anastomosis(SSVA) for portal hypertension(PH). Methods Tweenlve patients with PH (7 male and 5 female) underwent SSVA, average age 34±6.35 years (ranging from 26 to 54 years old). After splenectomy, the spleen vein and great saphenous vein were anastomosed. Results The pre and post operative average portal pressure was 29.38±2.75?cmH 2O, 24.68±2.55?cmH 2O respectively(P<0.01). The postoperative maximum velocity of portal vein was significantly decreased (from 19.86±8.65?cm/sec to 16.21±7.54?cm/sec), (P<0.01). The postoperative maximum volume also decreased significantly (from 1706.32±814.27?ml/min to 1323.02±630.52?ml/min)(P<0 01), The esophageal varices disappeared in 8 patients and improvement could be found in 3 cases despite 1 case unchangable. All of the patients were followed up for 1~4 years, neither hepative encephalopathy nor death was noted, and no hemorrhage of upper digestive tract occurred. Conclusions SSVA can effectively decrease the portal pressure and no hepative encephalopthy was found in this series. Therefore SSVA is vitwed as a simple, safe and effective operation for portal hypertension.
出处
《中国普通外科杂志》
CAS
CSCD
1999年第5期354-355,共2页
China Journal of General Surgery
关键词
门静脉高压
吻合术
脾静脉
大隐静脉
HYPERTENSION,PORTAL/SU ANASTOMOSIS,SURGILAL SPLENIC VEIN/SU