脾切断流术后再发上消化道出血的研究进展  

Research Advances of Recurrent Upper Gastrointestinal Bleeding after Splenectomy and Pericardial Devascularization

作　　者：吴振 尹琦 胡彦华[1] WU Zhen;YIN Qi;HU Yanhua(Department of General Surgery,the Second Affiliated Hospital of Harbin Medical University,Harbin 150086,China)

机构地区：[1]哈尔滨医科大学附属第二医院普外科,哈尔滨150086

出　　处：《医学综述》2020年第17期3465-3470,共6页Medical Recapitulate

摘　　要：脾切除联合贲门周围血管离断术是我国治疗门静脉高压的主要手术方式之一,其主要目的是预防和控制食管-胃底曲张静脉破裂引起的上消化道出血,同时消除脾大、脾功能亢进等临床症状,但手术治疗后一段时间内仍有部分患者再次出现呕血、黑便等上消化道出血症状,严重威胁患者的生命安全。目前认为,应激性溃疡、门静脉高压性胃病以及曲张静脉再次破裂出血是引起术后再发上消化道出血的主要原因,但尚未达成统一共识。未来还需要进一步探索预防和治疗术后再发上消化道出血的有效措施,规范不同原因引起出血的诊疗流程,以达到最佳治疗效果。Splenectomy and pericardial devascularization has always been one of the main surgical methods for the treatment of portal hypertension in China.Its main purpose is to prevent and control the upper gastrointestinal bleeding caused by the rupture of esophageal gastric varices,and to relieve the clinical symptoms of splenomegaly and hypersplenism.However,some patients still have the symptoms of hematemesis,black stool and other upper gastrointestinal bleeding in a period of time after the operation,which is a serious threat to the life of the patients.At present,it′s considered that stress ulcer,portal hypertensive gastropathy and variceal rebleeding are the main causes of postoperative upper gastrointestinal bleeding,but no consensus has been reached.In the future,it is necessary to further explore effective measures to prevent and treat postoperative upper gastrointestinal bleeding,standardize the diagnosis and treatment process of bleeding caused by different reasons,so as to achieve the best therapeutic effect.

关 键 词：术后再发上消化道出血 门静脉高压 脾切断流术 

分 类 号：R573.2[医药卫生—消化系统] R657.34[医药卫生—内科学]