摘要
外科治疗门脉高压症１９６例，急诊手术５７例，择期手术１３９例。计脾切除５７例，断流术８１例，分流术５８例。术后近期再出血２０例（１０．２％），住院死亡２２例（１１．２％）。认为单纯性脾切除虽可治愈脾亢，但远期并发食管贲门静脉曲张破裂出血率高（４３．９％）；断流术术式繁多，以食管贲门周围血管离断术较为方便易行，适于急诊止血；脾肾分流近期疗效满意，若与门奇断流术（Ｈａｓｓａｂ＇ｓ手术）联合应用，更符合门脉高压症之处理。此外，肠系膜上静脉与腔静脉端侧吻合术能选择性分流肠系膜区血流，减压效果确切，可用于脾切除或脾肾分流术后，以及断流术后再出血者。
96 cases with portal hypertension had undergone surgical treatments in the First AffiliatedHospital from l97O to l990,of which 57 cases were under emergence operations,139 cases underselective operations for portal hypertension, 57 cases under splenectomy, 81 cases under devascu-larization and 58 cases under shunts. 20 cases(10.2%)rebleed shortly after operation and 22cases ( 11.2%)died in the hospitalization period. It was held that the simple splenectomy couldcure hypersplenism,but the bleeding rate caused by the rupture of the cardiac varicose of theesophagus was high(43.9%). Many types of devascularization were reported, of which the para-esophageal cardiac devascularization was apt to be performed and suitable for emergence hemosta-sis. The recent therapeutic effects of splenorenal shunt were satisfying.If it was combined withporto-azygos devascularization, it would further accord with the handling principle of portal hy-pertension. In addition,the blood stream of the mesentary area could be selectively shunted bythe end-to-side anastomosis between superior mesentery vein and the inferior caval vein,and ifthe decompression effects were real, this method could be used after splenectomy or spleno-renalshunt、and for the rebleeding after devascularization.
出处
《温州医学院学报》
CAS
1994年第1期22-24,共3页
Journal of Wenzhou Medical College
关键词
门脉高压症
脾切除
断流术
分流术
portal hypertension,spleiiectomy
devascularization
shunt
