腹部异位曲张静脉的诊断和处理  

The diagnosis and management of abdominal ectopic varices

作　　者：王明堂[1] 应嘉钧[1] 

机构地区：[1]浙江省嘉兴市第一医院外科

出　　处：《普外临床》1997年第2期99-101,共3页

摘　　要：腹部异位曲张静脉常根据临床表现、手术所见或选择性动脉造影术确立诊断。本组共８例，其中６例为血吸虫病性肝硬变，１例妊娠，另１例原因不明（可能为先天性异常）。临床表现为消化道出血、腹内出血，尤其是上消化道再出血病例，甚易误诊。肝门区胆道曲张静脉在手术时也易误诊，可通过仔细缝补来治疗。早期诊断腹部异位曲张静脉可使用选择性动脉造影术。其处理包括直接缝扎、填塞压迫、肠段切除术和门腔分流术。全组病例术后均存活。Abstract:The diagnosis of abdominal ectopic varices was confirmed usually by the presence of ruptured varices and surgical finding or selective arteriography. 8 patients were reported,six of whom was schistosomiasis cirrhosis, one patient of pregnancy, and other one of unknown reason. The main presenting symptom was gastrointestinal tract bleeding and intraabdominal hemorrhage, especially, the patients with upper gastrointestinal (GI) tract recurrent bleeding is the most probably to be misdiagnosed. The common bile duct varices of hepatic hilus,at time of operation was most probably misdamaged and in treating these injuries, careful primary suture closure of the injury was performed. For the early diagnosis of abdominal ectopic varices, selective arteriography should be done. The management includs direct suture ligation of the varices and direct pressure packing, the segement bowel resection and portacaval shunt.All were survived．

关 键 词：腹部 异位静脉曲张 诊断 血管造影术 

分 类 号：R543.6[医药卫生—心血管疾病]