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球囊扩张术治疗Meso-Rex术后吻合口狭窄四例患儿疗效分析 被引量:1

Analysis of balloon venoplasties for anastomotic stenosis after Meso-Rex bypass in 4 children
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摘要 目的初步探讨球囊扩张术治疗肝外门静脉梗阻(EHPVO)Meso-Rex术后吻合口狭窄患儿的疗效。方法回顾分析2014年10月至2018年11月广州市妇女儿童医疗中心连续收治的60例EHPVO患儿资料,筛选Meso-Rex术后血管吻合口狭窄患儿4例,男性2例,女性2例,年龄分别为11岁、5岁、5岁、8岁。4例患儿行球囊扩张术。比较球囊扩张前后肝前门静脉压力、吻合口直径、吻合口血流速度等。随访患者术后情况。结果4例Meso-Rex术后血管吻合口狭窄患儿中3例成功实施球囊扩张,术后随访6个月,随访期间桥血管保持通畅,无消化道出血。1例患儿因吻合口狭窄段直径过小导致球囊扩张失败。3例患儿球囊扩张前肝前门静脉压力分别为19、15、25 mmHg(1 mmHg=0.133 kPa),扩张后分别为8、11、20 mmHg;术前吻合口直径分别为2.6、3.0、3.0 cm,术后6个月分别为6.0、4.5、5.5 cm;术前吻合口血流速度分别为138、107、94 cm/s,术后6个月分别为96、91、90 cm/s;术前CT三维重建脾脏体积分别为793.24、192.25、318.05 cm3,术后6个月分别为681.84、190.30、310.65 cm3。结论球囊扩张术可作为Meso-Rex术后吻合口狭窄一种供选择的治疗方式。 ObjectiveTo study the clinical outcomes of children with extrahepatic portal venous obstruction who underwent balloon venoplasties for anastomotic stenosis after Meso-Rex bypass.MethodsThe data of 60 patients who underwent Meso-Rex bypass at Guangzhou Women and Children’s Medical Center between October 2014 and November 2018 were retrospectively analyzed.Four patients were shown by transhepatic portal venography to have graft stenosis in the left portal vein anastomosis.There were 2 males and 2 famales,the age of patients were 11 years,5 years,5 years and 8 years.Four patients underwent balloon dilation.The pressure,anastomotic diameter and blood flow velocity of the anterior portal vein were compared before and after balloon dilation.The patients were followed-up on the postoperative status.ResultsThree of 4 patients who had anastomotic stenosis were successfully treated by balloon venoplasties.On postoperative follow-up for 6 months,the bridging vessels remained unobtrusive and there was no gastrointestinal bleeding.The pressures of the anterior hepatic portal vein before balloon dilation were 19,15 and 25 mmHg(1 mmHg=0.133 kPa).They were 8,11 and 20 mmHg after balloon dilation.The preoperative anastomotic diameters were 2.6,3.0 and 3.0 cm.They were 6.0,4.5 and 5.5 cm,respectively 6 months after surgery.The preoperative anastomotic blood flow velocities were 138,107 and 94 cm/s.They were 96,91 and 90 cm/s,respectively 6 months after surgery.The preoperative three-dimensional CT reconstruction of spleen volumes were 793.24,192.25,and 318.05 cm3,respectively.They were 681.84,190.30,and 310.65 cm3,respectively 6 months after surgery.In the remaining patient,balloon dilation failed because of the small diameter of the anastomotic stenosis segment.ConclusionBalloon venoplasties is an optional procedure for patients with anastomotic stenosis after Meso-Rex bypass.
作者 张宾宾 温哲 刘涛 梁奇峰 梁鉴坤 刘珍银 张向向 Zhang Binbin;Wen Zhe;Liu Tao;Liang Qifeng;Liang Jiankun;Liu Zhenyin;Zhang Xiangxiang(Department of Hepatobiliary Surgery,Guangzhou Women and Children’s Medical Center,Guangzhou 510000,China)
出处 《中华肝胆外科杂志》 CAS CSCD 北大核心 2020年第9期699-702,共4页 Chinese Journal of Hepatobiliary Surgery
基金 广东省科技厅科技计划项目(2014A020212026)。
关键词 门静脉 Meso-Rex术 吻合口狭窄 球囊扩张 Portal vein Meso-Rex Anastomotic stenosis Balloon venoplasties
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