摘要
目的探讨胰源性区域性门静脉高压(pancreatic segmental portal hypertension,PSPH)致上消化道出血的诊断和治疗方法。方法回顾性分析我院2010年1月至2017年12月收治的13例PSPH致上消化道出血患者的诊疗方法和随访资料.结果13例患者中胰腺假性囊肿5例,慢性胰腺炎8例,均有呕血或(和)黑便史,其中2例有失血性休克病史。所有患者均无肝硬化、门静脉血栓和肝功能异常等表现。13例均有孤立性胃底静脉曲张。13例患者均有脾大和脾功能亢进的表现,所有患者均行脾切除术。全部患者获得随访,曲张静脉明显改善或消失,随访1.8年均无再出血。结论脾切除术是治疗PSPH胃底静脉曲张破裂上消化道出血的首选,术前介入行脾动脉栓塞可减少脾脏切除难度。
Objective To investigate the diagnosis and treatment of upper gastrointestinal hemorrhage caused by pancreatic segmental portal hypertension. Methods The clinical diagnosis and follow-up data of 13 patients with upper gastrointestinal hemorrhage caused hy pancreatic segmental portal hypertension from Jan 2010 to Dec 2017 were retrospectively analyzed. Results Of the 13 patients, 5 had pancreatic pseudocysts and 8 had chronic pancreatitis. All of them had a history of hematemesis or (and) tarry feces, and 2 of them had a history of hemorrhagic shock. 13 patients had isolated gastric varices, and 5 of them had varicose veins in the lower esophagus. 13 patients had splenomegaly and hypersplenism, and all patients underwent splenectomy. All patients were followed up, and the varicose veins were significantly improved or disappeared. During 1 year to 8 years of follow-up, there was no rebleeding. Conclusion Splenectomy cures upper gastrointestinal hemorrhage caused by rupture of the varicose veins in patients of pancreatic segmental portal hypertension. Preoperative interventional spleen artery embolization can reduce the difficulty of spleen resection.
作者
朱卫华
谢文勇
张哲栋
郑晟旻
张大方
李澍
朱继业
冷希圣
Zhu Weihua;Xie Wenyong;Zhang Zhedong;Zheng Shengmin;Zhang Dafang;Li Shu;Zhu Jiye;Leng Xisheng(Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044 , China)
出处
《中华普通外科杂志》
CSCD
北大核心
2019年第3期193-195,共3页
Chinese Journal of General Surgery
关键词
高血压
门静脉
胰腺疾病
胃肠出血
Hypertension, portal
Pancreatic diseases
Gastrointestinal hemorrhage
