犬AbernethyⅠ型肝外门静脉分流的诊断及治疗分析

Diagnosis and Treatment of TypeⅠAbernethy Portosystemic Shunts in A Canine

肝外门静脉分流又称Abernethy畸形,根据肝内门静脉有无分支Abernethy畸形又分为AbernethyⅠ型和AbernethyⅡ型。AbernethyⅠ型在临床上较为罕见,国内外兽医文献中把结扎治疗列为AbernethyⅠ型的手术禁忌症,目前尚未见有关手术治疗的报道。作者在临床上接诊1例AbernethyⅠ型门静脉分流患犬,为了探讨该病例的治疗方案,借鉴医学文献中报道的有关方法,以诊断为目的进行手术,使用血管夹暂时阻断分流血管,配合肠系膜静脉造影,在X线下观察到在门静脉压升高的情况下,肝内出现微细的门静脉分支,尝试用Ameroid渐缩环闭合分流血管,最终取得良好的治疗效果。该手术的成功说明肝内门静脉系统存在着潜在的血运重建功能,可为兽医临床上AbernethyⅠ型畸形的诊断和治疗提供参考。

Portosystemic shunts,also known as Abernethy malformation,which divideds into Abernethy typeⅠand Abernethy typeⅡaccording to the presence or absence of branching of the intrahepatic portal vein.Abernethy typeⅠis rare in clinical practice,ligation therapy is listed as a contraindication to surgery in domestic and foreign veterinary literatures at present,and there is no report on the surgical treatment.The author clinically treated a dog with Abernethy typeⅠ.In order to explore the treatment plan of this case,the operation was performed for the purpose of diagnosis by referring to the relevant methods reported in the human medical literature.A vascular clip was used to temporarily block the shunt blood vessels,combined with mesenteric phlebography,microscopic portal vein branches were observed in the liver under the condition of elevated portal venous pressure under X-ray,and the Ameroid constrictor was tried to close the blood vessels,and finally a good therapeutic effect was achieved.The success of this operation indicated that the portal vein system has a potential reperfusion function,and provided a reference for the diagnosis and treatment of Abernethy typeⅠmalformation in veterinary clinic.