DSA在脾次全切除腹膜后移位加断流术治疗门脉高压症中的应用研究

Study on DSA in Treating Portal Hypertension by Subtotal Splenectomy with Retroperitoneal and Devascularization

目的 :探讨DSA检查在脾次全切除腹膜后移位加断流术治疗门脉高压症中的应用价值。材料与方法 :对 2 0例患者于术前、术后 2年分别行脾动脉DSA检查。结果 :DSA显示术前脾脏均呈不同程度增大 ,血管迂曲变形 ,部分脾脏与周围粘连组织建立了侧支循环 ;术后 2年余脾较手术保留时增大 ,均与腹膜后组织建立了丰富的侧支循环。结论 :DSA在术前诊断及术后疗效判定中具有重要价值。

Purpose: To study the value of DSA in treating portol hypertension by subtotal splenectomy with retroperitoneal splenic transposition and devascularization. Materials and Methods: Percutanous splenic artery DSA was performed in 20 patients with cirrhotic portal hypertension befor operation and 2 years after operation repectively. Results: Before operation spleen enlarged, splenic antery was curved and deformed, collateral circulation was formed between splenic and surrounding tissues in some cases. Whereas 2 years after operation residual spleen became larger than spleen retained intraoperation, abundant collateral circulation was built between the residual spleen and retroperitoned wall. Conclusion: DSA is valuable in preoperative diagnosis, retainning spleen during operation and evaluating therapeatic effect.