改良Sugiura手术联合脾腔分流术治疗门静脉高压症  

Combined Modified Sugiura Operation and Limited Splenocaval Shunt for Portal Hypertension

作　　者：郑立[1] 庞志刚[2] 刘超[2] 任学群[1] 孙嵩洛[1] 

机构地区：[1]河南大学淮河医院普外科,开封市475000 [2]郑州大学第二附属医院普外科,郑州市450014

出　　处：《医药论坛杂志》2006年第23期37-39,共3页Journal of Medical Forum

摘　　要：目的评估改良Sugiura手术联合限制性脾腔静脉分流术治疗门静脉高压症食管胃底曲张静脉破裂出血的疗效。方法对行改良sugiura手术联合限制性脾腔静脉分流术治疗的30例门静脉高压症患者的临床资料进行回顾性分析。结果术后自由门静脉(FPP)较术前平均下降(9.98±7.33)cm H2O(P<0.01),门静脉直径(PVD)由术前明显增粗(1.6±0.18)cm H2O逐渐恢复正常(1.4±0.14)cm H2O。门静脉最大血流速度(PVm ax)及血流量(PVF)明显降低。间置人造血管通畅,无明显血栓形成。本组30例无手术死亡和近期再出血。结论改良Sugiura手术联合人造血管间置限制性脾腔静脉分流术止血效果确切,可以使分流、断流术止血方面的优点相加,同时有效地防治了门静脉高压性胃病,并减少了肝性脑病的发生,而手术的难度和风险并未增加,因此不失为目前门脉高压症外科治疗的理想术式。Objective To evaluate the therapeutic effect of combined portoazygous devascularization and limited splenocaval shunt for the treatment of portal hypertension. Methods Retrospective analysis was made on 30 patients with portal hypertension undergoing combined modified sugiura operation and limited splenocaval shunt operation from 2001 to 2005. Results The average score of free portal pressure （FPP） after treatment was significantly decreased as compared with that before treatment by（9. 98 ± 7.33）cm H2O （ P 〈 0. 01 ）. the portal vein diameter（PVD） decreased from （1.6 ± 0. 18）cm H2O to （1.4 ± 0. 14）cm H2O. The artifical vessels is smooth and the thrombosis is not obvious. There is no death and hemorrhage in 30 patients undergoing selective operation. Conclusion The effects of combined operation to prevent hemorrhage is satisfactory. Combined operation can prevent portal hypertensive gastrophy effectively and decreased the rate of postoperative hepatic encephalopathy. Combined modified sugiura operation and limited splenocaval shunt is a rational surgical procedure in portal hypertensive surgery.

关 键 词：门静脉高压症 改良SUGIURA手术 人造血管 限制性脾腔静脉分流术 

分 类 号：R657.34[医药卫生—外科学]