切脾加分流术治疗血吸虫病门静脉高压症的远期随访  

Long-term follow-up of splenectomy plus portosystemic shunt in the treatment of portal hypertension in patients with schistosomal cirrhosis

作　　者：钱志祥[1] 应嘉钧[1] 周梅亭[1] 何毓椿[1] 

机构地区：[1]嘉兴市第一医院,血防医院外科,浙江省314000

出　　处：《中华肝胆外科杂志》2002年第1期22-24,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的　长期观察脾切除术附加门体分流术治疗血吸虫病肝硬化门静脉高压症的效果。方法　术后每年由基层血防专业人员随访记录 ,每隔 5～ 10年由外科医师检查 ,重点记录存活率、死亡原因及有关并发症。结果　所有病例分别随访 5～ 10年 ,11～ 2 0 ,2 1～ 30 ,31～ 40年 ,生存率分别为 73 7% ,6 1 5 % ,49 2 % ,32 8% ,比较各分流术式结果 ,以脾腔分流为佳。结论　血吸虫病肝硬化如有食道静脉曲张出血倾向者 ,手术治疗以脾切除附加脾腔端侧分流术为首选。Objective To observe the long-term effect of splenectomy in combination with portosystemic shunt in the treatment of portal hypertension due to schistosomiasis. Methods After the operation, annually regular follow ups by the medical staff of local clinics and by the surgeon every 5～10 years were conducted to record the survival rate, causes of death and postoperative complications. Results The survival rates of the follow ups for 5-10, 11-20, 21-30 and 31-40 years were 73 7%, 61 5%, 49 2% and 32 8%, respectively. The comparison between different modes of shunt indicated that spleno caval shunt was the most favorable due to its lower rebleeding rate and shorter time of operation. Conclusions Splenectomy in combination with spleno caval shunt is a safe and effective operative procedure for treatment of portal hypertension in patients with schistosomiasis and bleeding tendency.

关 键 词：门静脉高压症 脾切除术 门体分流术 血吸虫病 肝硬化 远期随访 

分 类 号：R657.3[医药卫生—外科学]