联合应用脾肾分流加贲门周围血管离断术治疗门脉高压症

TREATMENT OF PORTAL HYPERTENSION WITH SPLENONEPHRIC SHUNT PLUS LIGATION OF PERICARDIAL VEIN

目的 探讨联合应用脾肾分流加贲门周围血管离断术治疗门脉高压症的效果。方法 29例病人术前均确诊为肝硬化、门脉高压症,全部采用脾肾分流加贲门周围血管离断术治疗。结果 手术成功率达100%,术后自由门静脉压(FPP)降低有显著意义(P<0.01),术后随访6～24个月,患者食管胃底静脉曲张大部分消失,少部分有不同程度的改善,肝功亦有好转,无肝性脑病发生,无再出血。结论 脾肾分流加贲门周围血管离断术,既保留了断流术和分流术的优点,又克服了二者的缺点,是一种较理想的治疗门静脉高压症的手术方式。

Objective To explore the effect of the treatment of portal hypertension with splenonephric shunt plus ligation of pericardial vein.Methods 29 cases were all diagnosed as hepatocirrhosis and portal hypertension preoperatively,all of which were treated with splenonephric shunt plus ligation of pericardial vein.Results The rate of operative success was 100% and the postoperative free portal venous pressure dropped significantly(P<0.01).A postoperative follow-up survey for 6-24 months showed that the varices of esophagus and fundus of stomach in patients disappeared mostly,a smaller number improved to some extent ,and the liver function improved distinctly without any occurrence of hepatic encephalopathy and recurrent bleeding.Conclusion Splenonephric shunt plus ligation of pericardial vein on one hand,holds the advantages of both ligation and shunt and on the other hand,overcomes the disadvantages of both.So it is a fairly ideal operative method in the treatment of portal hypertension.