断流胃冠状静脉治疗胃底静脉曲张破裂出血都对吗?——谈区域性门静脉高压发病原因及临床诊治

Is blocking gastric coronary vein reasonable for the treatment of fundus variceal bleeding? —Progress in etiology, diagnosis and treatment of regional portal hypertension

区域性门静脉高压是胃底静脉曲张破裂出血的原因之一,如不能及时正确诊断及合理治疗,会危及患者生命。胃冠状静脉对于胃底静脉曲张具有重要意义;胃冠状静脉是肝硬化门静脉高压重要的供血通道,将其阻断对止血及预防再次出血具有重要意义;而对于区域性门静脉高压,胃冠状静脉是分流胃底曲张静脉血流的重要通道,如果将其阻断会加重胃底静脉曲张。本文将详细回顾导致区域性门静脉高压的病因,分析其血流动力学特点,并探讨其合理的治疗方法。

Regional portal hypertension is one of the reasons for fundus variceal bleeding. Without timely and correct diagnosis and proper treatment, it will endanger the lives of patients. The gastric coronary vein is important for gastric varices. For the patients with liver cirrhosis and portal hypertension gastric coronary vein is a critical blood supply channel, which needs to be blocked for the treatment of variceal bleeding. But for regional portal hypertension, gastric coronary vein is a critical bypass channel from fundus varicose vein to portal vein, which couldn＇t be blocked. This article will review the etiology and hemodynamic characteristics of the regional portal hypertension, and investigate the rational treatments.