改良式脾肾静脉分流术临床应用

CLINICAL STUDY OF MODIFIED SPLENORENAL SHUNT FOR THE TREATMENT OF PORTAL HYPERTENSION

目的 探讨改良式脾肾静脉分流术治疗门静脉高压症的效果。方法 用腹主动脉前脾肾静脉端侧吻合术 ,(改良式脾肾静脉分流术 )治疗门静脉高压症患者 5 2例。分别观察分流前后门静脉压力变化及食道胃底静脉曲张情况 ,再出血、肝衰竭的发生率及吻合口的通畅情况。结果 分流后门静脉压力平均下降 11cm H2 O,2 8例 (5 3.84% )患者食管胃底静脉曲张减轻 ,4例 (7.6 9% )患者发生再出血 ,6例 (11.5 4% )发生肝功能衰竭 ,长期随访 8例 (80 % ,8/ 10 )吻合口通畅。结论 改良式脾肾静脉分流是治疗门静脉高压症的较好术式之一。

Objective To investigate the therapeutical effects of modified splenorenal shunt for the treatment of portal hypertension .Methods Modified splenorenal shunts were performed with end-to-side anastomosis of splenic vein and renal vein in front of abdominal aorta for 52 fatients.Portal vein pressures were measured before and after the shunts were performed.Varix of esophagus was checked.The incidence rates of liver failure and rehemorrhage of upper digestive tract,and unobstructive rate of anastomotic stoma were studied postoperatively.Results The portal vein pressure declined 11cmH 2O averagely,Varix of esophagus were ameliorated in 28 patients(53.84%,28/52).Rehemorrhage of upper digestive tract occurred in 4 patients(7.69%,4/52).Liver failure occurred in 6 patients (11.5%,6/52).Anastomotic stoma were unobstructed in 8 out of 10 patients(80%,8/10)with long term follow-up survey.Conclusion Modified splenorenal shunt is one of the better surgical procedures for the treatment of portal hypertension.