胰源性门脉高压症病因探讨及46例临床分析  

Clinical study of 46 patients with pancreatogenic portal hypertension:specific features and treatment

作　　者：张明刚[1] 白如雪[1] 韩春丽[1] 杨华元[1] 

机构地区：[1]中日友好医院消化内科,北京100029

出　　处：《中日友好医院学报》2011年第6期323-325,共3页Journal of China-Japan Friendship Hospital

摘　　要：目的：探讨胰源性门脉高压症的病因、临床表现及治疗方法。方法：回顾分析我院1998年1月~2011年3月收治的46例胰源性门脉高压症患者的临床资料,分析其病因、诊断和治疗方法。结果：46例患者的原发疾病：慢性胰腺炎40例（87%）,胰腺肿瘤4例（8.7%）,胰腺囊肿（不包括合并胰腺炎者）2例（4.3%）。全部患者均有脾大,并伴有不同程度的胃底静脉曲张,其中7例同时合并食管静脉曲张。并发上消化道出血者25例（54.3%）。16例（34.8%）行手术治疗,脾脏切除术后预后良好;其他患者内科保守治疗后好转。结论：脾脏切除、胃底贲门周围血管离断是治疗胰源性门脉高压症可靠的手术方法。正确诊断,同时处理胰腺原发性疾病及其并发症是治愈胰源性门脉高压的关键。Objective：To study clinical specific features and treatment of pancreatogenic portal hypertension（PPH）.Methods：In this retrospective study,46 patients＇ clinical data between January 1998 and March 2011 were analyzed for investigating etiology,diagnosis and treatment of PPH.Results：Forty（87%） of all 46 patients had chronic pancreatitis,and the others included 4 patients（8.7%）with pancreatic tumor and 2（4.3%）with pancreatic cyst.Both splenomegaly and various grades of gastric varicose vein were diagnosed in all patients,but only 7 patients had gastroesophageal varicose.Upper gastrointestinal bleeding occurred in 25 cases（54.3%）.Sixteen（34.8%）patients experienced surgery and fully recovered.Conclusion：Splenectomy and epigastric blood vessel ligation are effective treatment for PPH.Right diagnosis and efficient management are the key points for the therapy of PPH.

关 键 词：门脉高压症 胰腺炎 胰腺肿瘤 

分 类 号：R657.34[医药卫生—外科学]