肝硬化门静脉高压症及其伴随腹部疾病的外科治疗  

Surgical treatment of cirrhotic portal hypertension and its accompanied abdominal diseases

作　　者：吴志勇[1] 陈炜[1] 

机构地区：[1]上海交通大学医学院附属仁济医院普通外科,200127

出　　处：《中华消化外科杂志》2013年第11期814-819,共6页Chinese Journal of Digestive Surgery

摘　　要：肝硬化门静脉高压症及其伴随腹部疾病的外科治疗仍是当前的医学难题之一。为了提高疗效，减少手术并发症发生率和病死率，术前必须对肝脏储备功能、门静脉高压症程度以及伴随腹部疾病，如胆道结石、胃肠道肿瘤、肝癌及腹壁癌等进行准确评估。门静脉高压症的术式选择必须依据患者的门静脉血流动力学状况。各种门体静脉分流术、断流术和分流＋断流的联合手术均有各自明确的适应证。在治疗伴随腹部疾病时，需兼顾对门静脉高压症的处理。只有掌握了手术原则、手术时机、手术方式、手术顺序、分期手术适应证以及术中关键技术等基本原理，才能为患者选择合理的术式，并尽可能以最小的手术创伤达到预期的治疗效果．Surgical treatment of cirrhotic portal hyper- tension and its accompanied abdominal diseases is one of the medical problems currently. Accurate evaluation of the hepatic function reserve, degree of portal hypertension and accompanied abdominal disease is important to decrease the postoperative mor- bidity and mortality as well as to raise the efficacy. The surgical procedure selection should be based on the analysis of portal vein hemodynamics of patients. There are clear indications for portosystemic shunt, devascularization and combinative surgery with shunt and devascularization. Treatment for portal hyperten- sion should be carried out when treating the accompanied abdom- inal diseases. The principle of operation, operation time, opera- tion mode, operation sequence, staging indications and the key techniques of operation were discussed in the article. Only these principles be mastered, proper selection of surgical procedures and desired treatment effect with minimal trauma can be achieved.

关 键 词：门静脉高压症 腹部疾病 外科手术 

分 类 号：R657.3[医药卫生—外科学]