经脾动脉灌注低分子右旋糖酐在门脉高压症断流术中的应用  

Application of perfusion of low molecular dextran via splenic artery in portal azygous devascularization for portal hypertension

作　　者：刘礼军[1] 余伟[1] 匡勇军 

机构地区：[1]湖北省汉川市人民医院、武汉大学人民医院汉川医院肝胆外科,汉川431600

出　　处：《中国血吸虫病防治杂志》2015年第6期650-652,共3页Chinese Journal of Schistosomiasis Control

摘　　要：目的探讨门脉高压症断流术中应用低分子右旋糖酐经脾动脉灌注,对预防门静脉系统血栓形成的效果。方法选取本院2009年1月-2013年10月门脉高压症断流术患者92例,随机分为2组,对照组46例行脾切除及贲门周围血管离断术,实验组46例行门脉高压断流术,且术中应用低分子右旋糖酐脾动脉灌注,对2组病例术后门静脉血栓发生率、术中术后输血量进行统计分析。结果实验组患者术后门静脉血栓发生率为4.3%（2/46）,浓缩红细胞输血量2~3U,对照组患者血栓发生率及浓缩红细胞输血量分别为26.1%（12/46）和4~6 U,差异有统计学意义（P均〈0.05）。结论术中经脾动脉低分子右旋糖酐灌注在门脉高压症脾切除术中操作安全可行,能有效降低术后门静脉系统血栓的发生率,且节约血源,减少用血量,值得临床推广应用。Objective To evaluate the effects of the perfusion of low molecular dextran via the splenic artery in portal azygous devascularization for portal hypertension in the prevention from portal vein thrombosis. Methods A total of 92 patients with portal hypertension were randomly divided into a control group（46 cases）that received the extensive devascularization around the cardia,and a trial group（46 cases）that received the above-mentioned operation and the perfusion of low molecular dextran via the splenic artery. The incidence of portal vein thrombus after the operation and the preoperative and postoperative blood transfusion were observed and the results were analyzed and compared between the two groups. Results The incidence of thrombosis and blood transfusion were 26.1%（12/46）and CRBC 4 ~ 6 U respectively in the control group,while those were4.3%（2/46）and CRBC 2 ~ 3 U respectively in the trial group. The differences were statistically significant（P〈0.05）. Conclu Conclusion The perfusion of low molecular dextran via the splenic artery in portal azygous devascularization for portal hypertension is effective and safe in the prevention from portal vein thrombosis.

关 键 词：肝硬化 门脉高压症 低分子右旋糖酐 脾动脉灌注 断流术 

分 类 号：R53[医药卫生—内科学]