门静脉高压症断流术的争议  

Disputes in devascularization for the treatment of portal hy-pertension

作　　者：李志伟[1] 张培瑞[1] 张绍庚[1] 

机构地区：[1]解放军第三〇二医院肝胆外科,北京100039

出　　处：《中华消化外科杂志》2013年第11期823-826,共4页Chinese Journal of Digestive Surgery

摘　　要：肝硬化共同的病理生理改变是肝功能损害和门静脉高压症，后者引起的上消化道出血是肝硬化患者最主要的死亡原因。因此，预防和控制食管胃底静脉曲张破裂出血是门静脉高压症主要的治疗目的。但无论是药物治疗还是内镜治疗、断流术还是分流术，都不能完全解决门静脉高压症引起的上消化道出血。虽然肝移植是最佳治疗手段，由于供肝、医疗条件等所限，断流术仍是我国比较可靠的防止门静脉高压症食管胃底静脉曲张破裂出血的手段，而对于手术适应证、手术时机以及术式选择等存在争议。A common pathophysiological changes caused by liver cirrhosis indudes damage of liver function and portal hypertension, and upper gastrointestinal hemorrhage caused by portal hypertension is the main cause of death in pa- tients with liver cirrhosis. Therefore, the main purpose of portal hypertension treatment should be prevention and control of esophagus and fundus of stomach variceal bleeding. However, upper gastrointestinal bleeding can not be completely cured no matter by medication or endoscopic treatment, devascularization or shunt. Although liver transplantation is the best treatment method for portal hypertension, the application of liver trans- plantation is limited by the source of donor and medical condi- tion. Devascularization is effective to treat upper gastrointestinal hemorrhage caused by portal hypertension, while disputes exist on the surzical indications, timing and procedure selection.

关 键 词：门静脉高压症 外科手术 断流术 

分 类 号：R657.3[医药卫生—外科学]