不同术式对肝前型门脉高压症门脉压力影响的实验研究  

Influence of Various Operative Methods on Portal Pressure of Prehepatic Portal Hypertension: An Experimental Study

作　　者：李振东[1] 赵莉[1] 于增文[1] 孙静生[1] 仲智勇[1] 

机构地区：[1]河北医科大学第二医院小儿外科,石家庄050000

出　　处：《中华小儿外科杂志》1999年第5期306-308,共3页Chinese Journal of Pediatric Surgery

基　　金：河北省自然科学基金!资助(395423)

摘　　要：目的　为了对肝前型门脉高压症的术式选择提供依据。方法　应用缩窄门静脉方法进行动物（犬） 的肝前型门脉高压症的模型制作。将已形成肝前型门脉高压症犬１８ 只分为４ 组，分别进行脾切除术、脾切除＋ 贲门周围血管离断术、肠腔分流术及联合手术。手术前后测定门脉压力进行对比。结果　与术前相比，脾切除有一定降低门脉压的作用（Ｐ＜ ０．０５）；肠腔分流术降压效果最佳（ Ｐ＜０．００１） ；脾切除＋ 离断术无明显降压作用；联合手术降压效果亦佳（ Ｐ＜ ０．０１） ，而肠腔分流术与联合手术相比降压效果无显著性差异（ Ｐ＞０ ．０５）。结论　肝前型门脉高压症的术式选择应根据术前全身状况、门脉压力增高程度并结合各种术式降压效果而定。Objective To explore the evidence of operative method selection of prehepatic portal hypertension (PPH). Methods Eighteen canine models of PPH was made using narrowing the portal vein. The models were divided into four groups namely, splenectomy, mesenterio caval shunt(MCS), splenectomy with periesophagocardiac vessel disconnection(PVD) and combined operation. The portal pressure was measured pre and postoperatively. Results The effect on portal decompression was excellent in MCS( P < 0.001 ), good in combined operation( P < 0.01 ), fair in splenectomy( P < 0.05 ). There was no obvious difference between MCS and combined operation( P < 0.05 ) in portal decompression. Conclusions The operation should be selected according to the state and degree of preoperative portal pressure of the patients, and the effect on portal decompression in various method. Three criteria for procedures selection are suggested.

关 键 词：门脉高血压 门脉压力 手术方式 实验研究 

分 类 号：R657.34[医药卫生—外科学]