分流断流联合术治疗肝硬化门脉高压症出血

目的:分析分流术、断流术的利与弊,探讨分流断流联合术式优势互补,治疗门静脉高压症出血的临床疗效。方法:对2001年至2005年4例门静脉高压症出血病人进行脾切除、脾肾静脉分流加贲门周围血管离断术,联合手术进行治疗。结果:4例门静脉压术后较术前平均降低0.89kPa,术后血常规及肝功能恢复正常,腹水消失,无肝性脑病和再出血发生,均康复出院。随访期间无再出血、肝性脑病、腹水及门静脉高压性胃病发生。结论:掌握好适应证开展分流加断流联合手术,在一定程度上能使二者优势互补,是一种理想的治疗门静脉高压症出血的术式。

Joined treatment of bypath and disconnection for hepatocirrhosis with portal hypertension bleeding

Objective To analyze the advantage and disadvantage of bypath and disconnection, research on the complementary advantages of joined treatment of bypath and disconnection ,and the clinical application of treating portal hypertension bleeding. Method Four patients suffering from portal hypertension bleeding were treated by joined method of splenectomy, spleno-renal bypath and disconnection of cardiac venous shunt from 2001 to 2005. Results Four cases of free portal vein blood pressure is reduced by an average of 0.89 kPa comparing with that before operation . After operation ,blood routine and liver function return to normal , ascites disappear , no hepatic enceohacopathy and no re-bleeding occur any longer . The patients all recover ,; no bleeding, no hepatic encephacopathy, ascites and portal hypertension gastropathy occur during follow-up visit. Conclusion By mastering a good indication, developing joined treatment of bypath and disconnection in some degree have complementary advantages which are an ideal treatment for portal hypertension bleeding .