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脾肾分流加门奇断流术治疗门静脉高压症(附58例报告) 被引量:1

Combined Splenorenal Shunt with Portoazygos Devascularization for Portal Hypertension
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摘要 目的 探讨脾肾分流加门奇断流术治疗门静脉高压症的效果。方法 回顾性分析 5 8例脾肾分流加门奇断流术的临床资料 ,其中男 41例 ,女 17例 ,平均年龄 42 .5岁 ;肝炎后肝硬变 5 1例 ,血吸虫肝硬变 7例 ;肝功能ChildA级 2 6例 ,B级 2 8例 ,C级 4例。行择期手术 3 9例 (ChildA级 2 0例 ,B级 18例 ,C级 1例 ) ;早期手术 10例 (ChildA级 3例 ,B级 6例 ,C级 1例 ) ;急诊手术 9例 (ChildA级 3例 ,B级 4例 ,C级 2例 )。结果 ChildC级 2例 (3 .4% )急诊手术死亡 ,其余均恢复 ,食管静脉曲张均消失或明显改善。 19例术后不同程度肝功能损害和 2 3例膈下积液、感染或胸腔积液 ,均经保守治疗治愈。 48例得到 5~ 10年随访 ,2例 (3 .4% )再出血 ,2例 (3 .4% )发生餐后脑病。 Objective To evaluate the effects of combined splenorenal shunt with portoazygos devascularization for portal hypertension. Methods A retrospective analysis of the clinical data of combined splenorenal shunt with portoazygos devascularization for portal hypertension in 58 cases was made. They were 41 male, 17 female and average age was 42.5 and post hepatitic liver cirrhosis in 51 cases, schistosomiasis cirrhosis in 7 cases, and Child A in 26 cases, B in 28, C in 4. There was selective operation in 39 cases (Child A 20, Child B 18, Child C 1), early operation in 10 (Child A 3, Child B 6, Child C 1) and emergency operation in 9 (Child A 3, Child B 4, Child C 2).Results All but two (3.4%) Child C cases died after emergency operation, the others recovered. Esophagus varicoses disappeared or had a great improvement in all cases. There were liver function damage with different degree in 19 cases and subdiaphramatic effusion or infection or pleural effusion in 23 and all were cured by conservative therapy. Followed up for 5-10 years in 48 cases, there were rebleeding in 2 cases (3.5%) and post meal encephalopathy in 2 (3.5%).Conclusion Combined splenorenal shunt and portoazygos devascularization are the first choice for portal hypertension at present.
作者 高琦 林擎天
出处 《中国普外基础与临床杂志》 CAS 2002年第4期258-260,共3页 Chinese Journal of Bases and Clinics In General Surgery
关键词 脾肾分流术 门奇断流术 联合手术 门静脉高压症 临床分析 手术方式 Splenorenal shunt Portoazygos devascularization Combined operation Portal hypertension
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