晚期血吸虫病门脉高压症脾动脉瘤的诊治

目的 探讨晚期血吸虫病门脉高压症中的脾动脉瘤(SAA)的诊治方法。方法 对1974年l0月--2000年12月诊治的12例脾动脉瘤回顾分析。结果 术前经彩色多普勒血流显像(CDFI)检查初步诊断l例，B超(BUS)检查怀疑诊断l例，其余l0例均在术中探查发现。动脉瘤直径1．8—3．5cm。动脉瘤连同巨脾一并切除3例；脾切除后，动脉瘤远近端血管均予缝结扎7例；仅作远端缝扎l例，术后因动脉瘤破裂死亡；动脉瘤切除l例。结论 晚期血吸虫病门脉高压症中的脾动脉瘤常与巨脾同存，且常在术中探查时发现。术中正确处理脾动脉瘤，合理治疗门脉高压症是取得良好疗效的保证。

SPLENIC ARTERY ANEURYSMS IN PATIENTS WITH ADVANCED SCHISTOSOMIASIS AND PORTAL HYPERTENSION

Objective To probe into diagnosis and treatment of splenic artery aneurysms (SAA) in patients with advanced schistosomiasis and portal hypertension. Methods Clinical data on 12 cases of SAA treated in the First Hospital of Jiaxing from January 1974 to December 2000 were analyzed retrospectively. Results One case was found by color duplex flow imaging (CDFI) and one was by BUS before operation. Other 10 cases were all found during operation period. The diameters of SAA ranged from 1.8 cm to 3.5 cm. Three aneurysms were excised together with splenectomy. Ligation of proximal and distal were done in 7 cases, one case excised the aneurysm, one case had distal ligation only and was death post-operation due to rupture of the aneurysm, after splenectomy. Conclusion The incidence of SAA in patients with advanced schistosomal portal hypertension is not very rare. If found during operation, proper management of SAA and portal hypertension is important in order to get good results.