断流和分流联合术治疗肝硬化门静脉高压症疗效观察

Long term effect of combined portoazygous devascularization and shunt for treatment of portal hypertension.

目的 观察断流和分流联合术治疗门静脉高压症的效果。方法 总结 1987年 4月至 1999年 4月采用断流加分流术治疗 5 6例门静脉高压症的经验。结果 择期手术 5 4例 ,无手术死亡。急症手术 2例 ,死亡 1例。术后随访 49例 ,再出血 1例 ,肝性脑病 2例 ,术后 4年因肝功能衰竭死亡 1例。术前门静脉压力平均为( 3 42± 0 46 )kPa ,术后为 ( 2 5 0± 0 35 )kPa。结论 断流加分流术既保留了断流术的优点 ,又降低了门静脉压力 。

Objective To evaluate the therapeutic effect of combined portoazygous devascularization and shunt on portal hypertension.Methods The data of 56 cases of portal hypertension treated with portoazygous devascularization and shunt from April 1987 to April 1999 was summarized.Results There was no death in 54 patients receiving selective operation;of 2 cases receiving emergency operation,one died.Among 49 followed up cases,there was one rebleeding,2 hepatic encephalopathy,and one died of liver failure 4 years after opeation.The mean portal pressure before and after operation was(3\^42±0\^46)kPa and(2\^50±0\^35)kPa,respectively.Conclusion Combined portoazygous devascularization and shunt not only decreases portal pressure but preserve hepatic blood flow to some extent.