肠腔侧侧分流术治疗门静脉高压症的临床研究

Clinical study of treatment of portal hypertension with mesentesiv caval side to side shunt

目的：探讨小口径肠腔侧侧分流术（ＭＣＳ－ＳＳ）治疗门静脉高压症的可行性。方法：将ＭＣＳ－ＳＳ的吻合口径控制在６～８ ｍ ｍ ，并观察了自由门静脉压（ＦＰＰ）、吻合口分流率（ＰＳＳａ）、门静脉向肝血流灌注（ＰＶＦ）及动脉血酮体比值（ＡＫＢＲ）等指标。结果：分流术后ＰＶＦ、ＡＫＢＲ、ＦＰＰ等均显著下降，但小口径组降幅明显小于对照组，ＰＳＳａ也明显低于对照组，而止血效果较对照组却无显著差别。结论：小口径ＭＣＳ－ＳＳ有助于提高门静脉高压症外科治疗的综合疗效。

Objective: To study the feasibility to treat portal hypertension with mesenteriocaval side to side shunt of small diameter. Methods: The diameter of the mesenteriocaval side to side shunt (MCS SS) was limited in the range of 6 to 8 cms. Then free portal pressure (FPP), the rate of portosystemic shunting through the anastomotic stoma (PSSa), portal vein flow (PVF) and the arterial ketone body rate (AKBR) were determined. Results: FPP, PVF and AKBR were significantly decreased after MCS SS but the extent of decrease was smaller in the experimental group than in the control. PSSa was also lower in the experimental group than in the control but there was no significant difference in stanching bleeding. Conclusion: MCS SS of small diameter improves comprehensively the surgical treatment of portal hypertension.