脾动脉缩窄式远端脾肾分流术七例

目的 探讨脾动脉缩窄式(splenic artery coarctation，SAC)远端脾肾静脉分流术(USRS-SRC)治疗门脉高压症的疗效。方法 7例肝硬化门脉高压症病人行DSRS-SAC术，术后随访3～11个月。术前和术后观察门静脉压力、门静脉直径和脾脏大小变化，以及外周血细胞计数、肝功能的改变。结果 DSRS-SAC术后脾胃区静脉压力明显下降(P＜0．01)，又能维持良好的向肝血流灌注，脾脏显著缩小（P＜0．01)，脾亢纠正，无肝性脑病和再出血。血清总胆红素升高(P＜0．05)，3例腹水一度增多。结论 DSRS-SAC是一种治疗门脉高压症可选择的较理想术式。

Splenic artery coarctation in distal splenorenal shunts: a report of 7 cases

ObjectiveTo evaluate the role of splenic artery coarctation in distal splenorenal shunts (DSRS-SAC) for treatment of portal hypertension. MethodsDSRS-SAC was performed in 7 cirrhosis patients with portal hypertension and all the patients were followed up for 3-11 months. The portal pressure, diameter of portal vein and size of spleen were recorded. The change in peripheral blood cell count and liver function were observed. ResultsDSRS-SAC could decompress the venous system in the gastroesphageal area (P<0.01) while maintain portal perfusion. The size of spleen was markedly reduced (P<0.01) and the hypersplenism improved. After the operation, there were no hepatic encephalopathy and variceal rebleeding. However, the total bilirubin was remarkably elevated (P<0.05). ConclusionsDSRS-SAC is reasonable and reliable for surgical management of portal hypertension causing esophageal and gastric varices.