胰源性区域性门静脉高压症的诊治体会  

Diagnosis and treatment of pancreatic sinistral portal hypertension

作　　者：周冰[1] 李强 周佳丽 兰朋训 俞明明 史燕巧 Zhou Bing;Li Qiang;Zhou Jiali;Lan Pengxun;Yu Mingming;Shi Yanqiao(Department of Radiology, Traditional Chinese Medicine Hospital of Jiaxing, Jiaxing 314001,China;Department of Radiology, Yinzhou People's Hospital of Ningbo, Ningbo 315040, China;Departmentof Radiology, Traditional Chinese Medicine Hospital of Zhejiang Province, Hangzhou 310006, China)

机构地区：[1]浙江省嘉兴市中医医院放射科,314001 [2]浙江省宁波市郵州人民医院放射科,315040 [3]浙江省中医院放射科,杭州310006

出　　处：《中华普通外科杂志》2019年第6期527-529,共3页Chinese Journal of General Surgery

基　　金：浙江省医药卫生科技计划青年人才项目(2019RC273);宁波市社会发展项目(201701CX-D02160).

摘　　要：目的总结胰源性区域性门静脉高压症(pancreatic sinistral portal hypertension, PSPH)的临床诊治经验。方法回顾性分析28例PSPH患者的临床资料,总结该病的临床特点和诊治经验。结果本组28例PSPH患者均存在原发性胰腺疾病,其中胰腺炎16例,胰腺体尾部肿瘤12例。行胰体尾部切除+脾脏切除12例,脾脏切除+贲门周围血管离断术2例,胰体尾切除+引流术9例。另有5例采用非手术内科治疗。术后患者获1年以上随访,存活20例。5例保守治疗患者中2例仍有反复上消化道出血。结论PSPH手术治疗效果良好,但需依据原发病情况选择个体化手术方案。Objective To analyze the diagnosis and treatment of pancreatic sinistral portal hypertension ( PSPH). Methods A total of 28 patients with PSPH were retrospectively analyzed, and the clinical characteristics, diagnosis and treatment experience of the disease were summarized. Results There were primary pancreatic diseases in all the cases, including 16 cases of pancreatitis and 12 cases of pancreatic tumor in the tail. 12 cases underwent distal pancreatectomy plus spleenectomy, 2 cases did spleenectomy and pericardial devascularization, 9 cases received miscellaneous surgical procedures, and 5 case were managed by non-surgical medical treatments. After 1 year of follow-up, 20 of 23 postoperative patients were alive and well. Among the 5 conservatively treated patients, 2 had repeated upper gastrointestinal bleeding. Conclusion PSPH, especially caused by chronic pancreatitis yields to personalized surgical procedures based on pancreatectomy.

关 键 词：高血压 门静脉 胰腺疾病 外科手术 

分 类 号：R576[医药卫生—消化系统]