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手术中门静脉急症的处理 被引量:1

Management of portal vein emergency on operating
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摘要 目的研究手术中门静脉急症的处理。方法对5例门静脉急症的临床资料进行分析,并复习有关文献。结果本组5例中,医源性4例,其中胆道再次手术2例(1例合并门静脉高压症),胰十二指肠切除术、经颈内静脉肝内门体静脉分流术(TIPS)各1例;外伤1例。发生门静脉破裂4例,门静脉急性栓塞1例。5例均并发低血容量性休克,平均输血2700ml。2例合并多器官功能衰竭,其中心-肺型、肝-肾型各1例,合并急性肾功能衰竭3例。本组均一期处理,行门静脉修复3例,门静脉侧支缝扎止血1例,门静脉切开取栓术1例,同时给予抗休克等抢救措施。5例均治愈,术后近期随访疗效良好。结论手术中门静脉急症可引起严重的临床问题,应给予高度重视。针对其原因的多样性,详细了解围肝门部区域解剖关系和各种门静脉急症的处理原则,术中有预见性地采取预防措施,是提高手术疗效的关键。 ObjectiveTo study the management of portal vein emergency on operating.Methods5 cases of portalvein emergency on operating were analyzed and literatures were reviewed.ResultsIn 5 cases,4 cases were caused byiatrogenic problems. 2 cases underwent reoperation by biliary tract and one of them was portalhypentation,pancreatodudenectomy 1 case,TIPS 1 case and trauma 1 case.There were rupture hemorrhage 4 cases and acuteembolism of portal vein 1 case.All the patients had hypovolemic shock and the average blood transfusion were 2700ml.Therewere MOF 2 cases which were AHaF-ARDS type 1 case and FRF-AHeF type 1 case,and there were ARF 3 cases.The managementmethods were portal vein repaired 3 cases、 the collateral branch of portal vein ligated 1 case and the embolectomy of portalvein 1 case.All the 5 patients were cured.The results of follow-up were satisfied. ConclusionsPortal vein emergency onoperating can cause the severe clinic problems and should be attached great importance.Its the key to improve the operativecurative effect that we should acquire the detailed anatomic specialities of the perihepatic portal region and master themanagement principles.
出处 《罕少疾病杂志》 2003年第3期9-11,共3页 Journal of Rare and Uncommon Diseases
关键词 手术 门静脉急症 外科治疗 肾功能衰竭 临床资料 rupture of portal vein embolism of portal vein emergency surgical treatment
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