应用带环人造血管行门腔分流治疗门静脉高压症

Application of artificial blood vessel ring to portaca val shunt for portal hypertension

目的 探索应用带外支撑环人造血管行门腔分流治疗门脉高压症的疗效。方法 用内径 8.0和10 .0mm带外支撑环的膨体聚四氟乙烯人造血管 (PTFE)对 2 0例肝硬化门脉高压症患者进行了门腔静脉间的分流术。其中肝功能ChildA级 10例 ,B级 8例 ,C级 2例。结果 1例术后 3d死于DIC。脑病 1例。存活 19例术后平均随访 1年 ,无肝性脑病 ,未再出现腹水 ,无曲张静脉破裂再出血。术后彩色多普勒超声检查PTFE血管桥 19例通畅 ,向肝血流无明显影响。结论 该技术在保持分流人造血管通畅减低门静脉压力 ,维持向肝血流 ,预防再出血 ,消除腹水等方面效果良好。

Objective: To probe the effect of application of artificial blood vessel with ring in port acaval shunt for portal hypertension. Methods:Portacaval shunt u sing 8.0 mm or 10 mm diameter PTFE graft with supporting ring were performed in 20 patients including Child A in 10 cases,Child B in 8 cases and Child C in 2. Results:1 patient was died by DIC in third day after operat ion and encephalopathy occurred in 1 case. The other 19 case for a mean follow u p period of 12 months were no encephalopathy or reblooding from rapture varices and reappearing ascites. Postoperative color Doppler ultrasonography showed that the all shunt were canalizating and the hepatopetal blood flow was no change af ter operation. Conclusion: This portacaval shunt is effective to decompress portal pressure ,ensure the hepatopetal blood flow,abate ascites and prevent reblooding.