TIPSS与改良Sugiura术联合治疗门静脉高压症的临床研究  

Combined TIPSS with modified Sugiura operation for portal hypertension

作　　者：吴性江[1] 黎介寿[1] 曹建明[1] 吴学豪[1] 韩建明[1] 

机构地区：[1]南京军区南京总医院外科

出　　处：《中华外科杂志》1999年第4期216-218,I013,共4页Chinese Journal of Surgery

摘　　要：目的研究ＴＩＰＳＳ与改良Ｓｕｇｉｕｒａ术联合治疗门静脉高压症的临床疗效。方法对２４例门静脉高压症患者因出血和腹水采用ＴＩＰＳＳ和改良Ｓｕｇｉｕｒａ术联合治疗。结果ＴＩＰＳＳ与改良Ｓｕｇｉｕｒａ术后患者出血停止，腹水消退，门静脉压力显著下降（Ｐ＜００１），门静脉血流速度增快（Ｐ＜００１），肝内分流道血流速度为（１３２６４±４１４２）ｃｍ／ｓ，直接门静脉造影示冠状静脉完全消失，肝功能无明显改变。术后２年随访，无出血复发，肝内分流道通畅。结论ＴＩＰＳＳ与改良Ｓｕｇｉｕｒａ术联合应用，既能降低门静脉压力，改善门静脉循环，又能有效阻断冠状静脉，维持肝脏功能，具有良好的临床疗效。Objective To evaluate the clinical results of combined TIPSS with modified Sugiura operation for portal hypertension. Methods 24 patients with portal hypertension associated with variceal bleeding and ascites were treated with TIPSS and then modified Sugiura operation two weeks later. Results After combined TIPSS with modified Sugiura operation, variceal bleeding ceased and ascites subsided. The portal pressure significantly decreased ( P <0 01) and the portal blood flowed quickly ( P <0 01). The blood velocity of intrahepatic shunts was (132 64±41 42) cm/s. Direct portal venography showed that coronary vein had disappeaed. No rebleeding was moted in varices and stenosis in intrahepatic shunts. Conclusions Combined TIPSS with modified Sugiura operation not only can reduce portal pressure and improve portal circulation, but also completely interrupt coronary vein and maintain liver function.

关 键 词：门脉高压症 门奇断流术 门腔分流术 SUGIURA术 

分 类 号：R657.340.5[医药卫生—外科学]