合并甲状腺机能亢进的门静脉高压症的治疗  

Management of portal hypertension complicated with hyperthyroidism.

作　　者：王新保[1] 杨镇[1] 李德旭[1] 邓小荣[1] 李大鹏[1] 裘法祖[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院,武汉430030

出　　处：《中国实用外科杂志》2001年第3期152-153,共2页Chinese Journal of Practical Surgery

摘　　要：目的　总结合并甲状腺机能亢进 (简称甲亢 )的门静脉高压病人的处理经验。方法　 5例合并甲亢的门静脉高压症病人经积极的术前准备后均行脾切除加贲门周围血管离断术。对术前、术后的处理经验进行了总结。结果　 5例病人中有 1例术后出现甲状腺危象 ,经镇静、应用强地松和碘化钠等治疗后恢复 ,余 4例均顺利通过了围手术期 ,WBC、RBC、Hb、Pt分别由术前的 ( 2 0 18± 0 5 36 )× 10 9/L、( 2 97± 0 42 )× 10 12 /L、( 87±15 6 ) g/L、( 38 4± 13 2 4)× 10 9/L上升到术后的 ( 6 5 4± 0 398)× 10 9/L、( 3 6 36± 0 387)× 10 12 /L、( 10 8 6±9 6 33) g/L、( 2 40 4± 84 5 4)× 10 9/L ,全部病人的白细胞及血小板术后均达到正常水平。结论　合并甲亢的门静脉高压症如经过适当的处理 ,可使病人顺利通过脾切加贲门周围血管离断术的手术治疗 。Objective To summarize the experience of managing portal hypertension(PHT)complicated with hyperthyroidism.Methods 5 patients with hyperthyroidism complicated PHT were performed with splenectomy plus pericardial devascularization after preoperative management,and the experience of pre and postoperative management was summarized.Results 1 patient occurred postoperative thyroid crisis and was cured with tranquilizing,prenisone and sodium iodide;the other 4 went through perioperation safely.The preoperative WBC,RBC,Hb and Pt were(2 018±0 536)×10 9/L,(2 97±0 42)×10 12 /L,(87±15 6)g/L and (38 4±13 24)×10 9/L,respectively,which rose to (6 54±0 398)×10 9/L,(3 636±0 387)×10 12 /L,(108 6±9 633)g/L and (240 4±84 54)×10 9/L,respectively after operation.WBC and platelets of all patients reached normal level postoperatively.Conclusion Proper perioperative management ensures that patients with hyperthyroidism complicated PHT survive the splenectomy plus pericardial devascularization,which renders opportunity for treating hyperthyroidism with medicine or surgery.

关 键 词：甲状腺机能亢进 门脉高压症 并发症 治疗 

分 类 号：R657.34[医药卫生—外科学] R581.1[医药卫生—临床医学]