68例左侧门脉高压症临床分析  

Clinical analysis of 68 cases of left-sided portal hypertension

作　　者：楚毅[1] 朱洪怡[1] 霍继荣[1] 

机构地区：[1]中南大学湘雅二医院消化内科,湖南长沙410011

出　　处：《胃肠病学和肝病学杂志》2012年第7期652-655,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨左侧门脉高压症(left-sided portal hypertension,LSPH)的临床特点。方法回顾性分析我院2006年4月-2011年4月68例LSPH患者的临床资料。结果 68例患者中4例为胃底合并食管静脉曲张,46例为孤立性胃底食管,18例静脉曲张,临床表现主要以上消化道出血(38例)和腹痛(36例)为主;所有患者均可发现脾大脾亢;肝功能均正常。导致LSPH的原发疾病中,胰源性占多数(41例),其中慢性胰腺炎最多;非胰源性疾病有左肝癌、门静脉海绵样变、脾脓肿、淋巴瘤等疾病。结论导致左侧门脉高压症的原发疾病多种多样。临床特点:脾大脾亢、孤立性胃底或食管静脉曲张、肝功能正常。结合内镜和多种影像学手段,诊断并不困难。LSPH治疗要遵循个体化原则,以治疗原发疾病为基础,根据具体情况选择对症治疗的方法。预后因原发疾病不同而有很大差别。Objective To analyze the clinical features of patients with left-sided portal hypertension （LSPH）. Meth- ods The clinical data of 68 inpatients with LSPH in the Second Xiangya Hospital of Central South University from Apr. 2006 to Apr. 2011 were analyzed retrospectively. Results In all 68 patients, 4 cases were fundal with esophageal vari- ces, 46 cases were isolated fundal varices and 18 cases were esophageal varices. The mainly clinical presentations of LSPH were upper gastrointestinal hemorrhage （38 cases） and abdominal pain （36 cases）. All patients appeared spleno- megaly, hypersplenia, and normal liver function. There were 41 cases associated with pancreatic diseases, and chronic pancreatitis were the most. Many nonpancreatic diseases also led to LSPH, for example, left lobe liver cancer, cave- mous transformation of portal vein, splenic abscess and lymphoma. Conclusion Left-sided portal hypertension has vari- ous etiologies. Splenomegaly, hypersplenia, isolated fundal or esophageal varices, normal liver function are the LSPH＇ s clinical features. It is not very difficult to diagnose LSPH endoscopically and radiologically. Treatment should be direct- ed at the underlying diseases and individualization. Prognosis may be different depends mainly on the underlying etiolo- gY.

关 键 词：左侧门脉高压症 临床分析 原发疾病 

分 类 号：R575.21[医药卫生—消化系统]