胰源性门静脉高压症23例诊治分析  

Diagnosis and treatment of pancreatic segmental portal hypertension： An analysis of 23 cases

作　　者：钟翔宇[1] 赵学林[1] 温天富 康鹏程[1] 姜兴明[1] 王志东[1] 崔云甫[1] 

机构地区：[1]哈尔滨医科大学附属第二医院胆胰外科,哈尔滨150086

出　　处：《腹部外科》2015年第6期381-385,共5页Journal of Abdominal Surgery

基　　金：黑龙江省自然科学基金项目（H201396）;黑龙江省科技厅攻关基金资助项目（GC12C304～1）

摘　　要：目的探讨胰源性门静脉高压症（PSPH）的诊断及治疗方法。方法回顾性分析自2010年1月至2014年12月诊治的23例PSPH病人的临床资料，其中男性14例，女性9例；年龄24～73岁，平均年龄46岁，23例病人均是初次诊断和治疗。18例接受手术治疗，4例保守治疗，1例行介入下脾动脉栓塞。结果本组23例病人原发疾病中慢性胰腺炎10例，胰腺假性囊肿6例，胰腺肿瘤5例，急性胰腺炎1例，创伤性胰瘘1例。23例均有脾肿大伴脾功能亢进，6例出现呕血或黑便。21例病人获得随访，随访率为91％，随访6～66个月。随访期间1例病人出现再出血，2例病人死于胰腺恶性肿瘤。结论PSPH兼有原发病和区域性门静脉高压症的临床特点，治疗原则应针对原发病，遵循多学科联合的个体化治疗方案。Objective To investigate the diagnosis and treatment of pancreatic segmental portal hypertension （PSPH）. Methods Twenty-three cases of PSPH treated in our hospital from January 2010 to December 2014 were analyzed retrospectively. Results There were 14 males and 9 females. The primary diseases included chronic pancreatitis （n = 10）, pancreatic pseudocyst （n = 6）, pancreatic cancer （n = 5）, acute pancreatitis （n = 1）, and traumatic pancreatic fistula （n = 1）. All the 23 patients presented with splenomegaly and hypersplenism, including 6 cases with vomiting blood or black stools. Eighteen patients received operative treatment, 4 patients were treated conservatively, and 1 patient were subjected to splenic artery embolization. Twenty-one patients were followed up from 6 months to 66 months and the follow-up rate was 91%. During the follow-up period, rehaemorrhage occurred in one patient and two patients died of pancreatic malignant tumor. Conclusions PSPH has the clinical characteristics of primary disease and segmental portal hypertension. The principle of treatment should focus on the primary disease and abide by individualized therapy programs by multidisciplinary team （MDT）.

关 键 词：门静脉高压症 胰腺疾病 个体化治疗 

分 类 号：R657.34[医药卫生—外科学]