肝移植时代门静脉高压症的治疗选择  

Treatment options for portal hypertension in the era of liver transplantation

作　　者：徐骁[1] 郭海军[1] 李望遥 Xu Xiao;Guo Haijun;Li Wangyao(Department of Hepatobiliary and Pancreatic Surgery,First Affiliated Hospital,Zhejiang University School of Medicine,Research Institute for Organ Transplantation of Zhefiang University,Hangzhou 310003,China)

机构地区：[1]浙江大学医学院附属第一医院肝胆胰外科 浙江大学器官移植研究所,杭州310003

出　　处：《中华消化外科杂志》2018年第10期992-996,共5页Chinese Journal of Digestive Surgery

基　　金：国家科技重大专项（2017ZX100203205）;教育部长江学者奖励计划

摘　　要：肝移植使门静脉高压症的根治成为可能，以肝移植为主的多种治疗手段联合应用的新格局已趋形成。脾切除术、断流术、经颈静脉肝内门体分流术等多种传统治疗手段对肝移植受者转归可产生重要影响。门静脉狭窄、门静脉血栓形成和小体积供肝等因素导致肝移植术后门静脉高压状态及移植肝失功。笔者就此探讨了多种传统治疗方式对受者预后的影响及肝移植术后门静脉高压状态的处理，以期寻求最优治疗策略。Liver transplantation makes it possible to cure portal hypertension thoroughly. A new pattern of combined application of multiple treatments based on liver transplantation has emerged. Conventional surgical treatments such as splenectomy, devascularization and transjugular intrahepatic portosystemic shunting have important effects on the prognosis of liver transplant recipients. Portal vein stenosis, thrombosis as well as small-for-size liver graft lead to post-transplant portal hypertension and liver dysfunction. The author in this article provides an overview of the effects of various conventional treatments on the prognosis of recipients and the treatment of portal hypertension after liver transplantation, aiming to seek for optimal strategy.

关 键 词：门静脉高压症 肝移植 治疗 预后 

分 类 号：R657.3[医药卫生—外科学]