脾肾分流加门奇断流联合术治疗门静脉高压症

对1978年4月至1996年5月施行脾肾分流加门奇断流联合治疗门静脉高压症的128例患者进行了回顾性研究。其中35例用彩色多普勒超声显像观察了手术前后门脉系血流动力学变化,10例采用数字减影血管造影检查,并就15例门奇断流术进行了对比分析。结果显示:联合术既保留了断流术的优点,同时又可适当降低门静脉的压力和血流量,改善门脉系高血流瘀血状态,且维持一定量的向肝血流。手术死亡车为3.9％,术后迫期无1例出血,远期出血率为8.1％,肝性脑病发生率为4.6％,5、10年及15年生存率分别为81.2％、69.1％和58.5％。作者认为该联合术是目前治行门静脉高压症的一种合理而可取的术式

LONG TERM RESULTS OF SPLENORENAL SHUNT WITH PORTAAZYGOUS DEVASCULARIZATION FOR PORTAL HYPERTENSION

The 128 cases of portal hypertension treated with splenorenal venous shunt combined with portaazygous devascularization from April 1978 to May 1996 were summarized. The operative mortality was 3. 9% , no short - term postoperative bleeding, long term postoperative bleeding rate was 9.7%, hepatic en-cephaloputhy rate was 4.6%, Five years, ten years and fifteen years survival rates were 81. 2 % , 69.1 % and 58. 5% respectively. The portal hemodynamics was observed with DCFI on 35 patients,and compared with 15 post - portaazygous devascularization patients. Ten patients analysed by DSA simultaneously. It showed that combined splenorenal shunt with portaazygous devascularization not only conserved the advantages of devaseularization procedure, but also decreased the portal venous pressure and blood volume, relieved the state of portal stasis, and preserved hepatotropic blood in some degree. The authors believe that the combined procedure is an appropriate operation for portal hypertension.