胰源性门静脉高压症的个体化治疗方法选择  

Individualized treatment of pancreatic portal hypertension

作　　者：楼文晖[1] 李剑昂[1] 

机构地区：[1]复旦大学附属中山医院普外科,上海200032

出　　处：《中国实用外科杂志》2014年第1期28-29,共2页Chinese Journal of Practical Surgery

摘　　要：胰源性门静脉高压症是一组因胰腺疾病造成脾静脉血液回流受阻而引起的临床征候群,主要表现为脾脏肿大、脾胃区静脉曲张而肝功能无异常。常见于慢性胰腺炎、胰腺肿瘤和假性囊肿导致脾静脉内膜炎症或压迫脾静脉,造成脾静脉阻塞。胰源性门静脉高压症治疗方案的选择,应以针对原发病为主,结合门静脉高压症状的严重程度,掌握适当的指征和时机。一般无出血的病人,可在处理胰腺原发病的基础上作脾切除术;对有出血的病人,还应附加断流术。原则上脾动脉栓塞和内镜治疗适用于身体状况比较差,不能耐受手术治疗的病人。Pancreatic portal hypertension is a clinical syndrome characterized by splenic vein obstruction caused by pancreatic disease. The main clinical manifestation are splenomegaly, gastric varices while no liver function abnormality. Splenic vein obstruction are usually caused by endothelium inflammation and external compression induced by chronic pancreatitis, pancreatic tumor and pseudocyst. The treatment principle should be focus on the primary disease while considering the severity of sinistral portal hypertension. For patients without bleeding, splenectomy is suggested after the surgical treatment of primary pancreatic disease; for bleeding patients, devascularization should be considered. Generally, splenic artery embolism and endoscopic treatment are only considered in the acute setting or the nonoperative candidate

关 键 词：胰腺疾病 门静脉高压症 

分 类 号：R6[医药卫生—外科学]