断流术在肝硬化门静脉高压中的作用及争议  

The role of devascularization in cirrhotic portal hypertension and related controversies

作　　者：徐伟 涂兵[1] XU Wei;TU Bing(Department of Hepatobiliary Surgery,The Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院肝胆外科,重庆400010

出　　处：《临床肝胆病杂志》2020年第3期670-672,共3页Journal of Clinical Hepatology

摘　　要：门静脉高压所致的胃-食管静脉曲张破裂出血及脾功能亢进等严重威胁到肝硬化患者的生命。目前外科断流术仍是治疗门静脉高压的重要术式之一,但药物、内镜及介入等治疗方式的兴起,使得断流术在门静脉高压治疗中的作用、手术指征、手术时机以及脾切除与否等受到争议。对断流术的作用及争议进行阐述分析,指出目前断流术仍是不可替代的,而门静脉高压的治疗应以个体化、综合性、微创为原则,尽可能带给患者最小的创伤、最大的受益。Gastroesophageal variceal bleeding and hypersplenism caused by portal hypertension seriously threaten the life of patients with liver cirrhosis.At present,devascularization is still one of the important surgical procedures for the treatment of portal hypertension;however,the development of the treatment methods such as drugs,endoscopy,and interventional treatment has caused the controversies over the role,surgical indications,and surgical timing of devascularization in the treatment of portal hypertension,as well as whether splenectomy is needed.This article reviews the role of devascularization and related controversies and points out that devascularization is still irreplaceable.Individualized,comprehensive,and minimally invasive treatment regimens should be developed for portal hypertension,so as to bring maximum benefits to patients with minimal invasiveness.

关 键 词：肝硬化 高血压 门静脉 食管和胃静脉曲张 断流术 

分 类 号：R657.34[医药卫生—外科学]