CAJ | 학술논문

目的探讨肠腔分流并选择性冠状血管缝扎术对成人门静脉海绵样变性的治疗作用及临床价值.方法对郑州大学第一附属医院收治的28例成人门静脉海绵样变性并行肠腔分流、脾动脉结扎、选择性冠状静脉缝扎术治疗患者的临床资料结合国内外资料进行回顾性分析.采用SPSS17.0统计软件对数据进行分析,两样本均数的比较采用t检验.结果本组无手术死亡病例,分流后自由门静脉压力平均下降9.8 cm H2O(1 cm H2O=0.098 kPa),术后并发轻微肝性脑病2例,乳糜漏3例,应激性溃疡出血1例,均通过非手术治疗后痊愈.26例得到随访,血氨正常,人工血管均通畅.2例再发出血,1例行脾切断流术,1例行改良脾肺固定术.结论肠腔分流并选择性血管缝扎术对成人门静脉海绵样变性是安全有效合理的手术方式.
목적 탐토장강분류병선택성관상혈관봉찰술대성인문정맥해면양변성적치료작용급림상개치.방법 대정주대학제일부속의원수치적28례성인문정맥해면양변성병행장강분류、비동맥결찰、선택성관상정맥봉찰술치료환자적림상자료결합국내외자료진행회고성분석.채용SPSS17.0통계연건대수거진행분석,량양본균수적비교채용t검험.결과 본조무수술사망병례,분류후자유문정맥압력평균하강9.8 cm H2O(1 cm H2O=0.098 kPa),술후병발경미간성뇌병2례,유미루3례,응격성궤양출혈1례,균통과비수술치료후전유.26례득도수방,혈안정상,인공혈관균통창.2례재발출혈,1례행비절단류술,1례행개량비폐고정술.결론 장강분류병선택성혈관봉찰술대성인문정맥해면양변성시안전유효합리적수술방식.
Objective To investigate the clinical effect of mesocaval shunt combined with selective vascular ligation for portal hypertension caused by cavernous transformation of the portal vein in adults.Methods The clinical data of 28 adult patients with portal hypertension caused by cavernous transformation of the portal vein treated by mesocaval shunt plus splenic artery combined with coronary vein ligation were retrospectively analyzed.SPSS17.0 statistical software was used for data analysis,two sample t test was used for comparing.Results There was no operative death case,free portal pressure after shunt decreased 9.8 cm H2O( 1 cm H2O =0.098 kPa),postoperative complications included slight hepatic encephalopathy in 2 cases,chylous leakage in 3 cases,stress ulcer bleeding in 1 case,which were cured by conservative treatment.Twenty-six cases were followed up,normal blood ammonia,artificial blood vessels were unobstructed.Rebleeding in 2 cases,1 case was performed with splenopneumopexy,1 case was performed with splenectomy plus pericardial devascularization.Conclusions Mesocaval shunt combined with selective vascular ligation for portal hypertension caused by cavemous transformation of the portal vein in adults is a safe and effective operative method.