CAJ | 학술논문

目的探讨左上腹恶性肿瘤所致的区域性门静脉高压的病因、临床特点和治疗方法.方法回顾性分析2006年1月至2009年12月上海交通大学医学院附属瑞金医院收治该类肿瘤源性区域性门静脉高压8例患者的临床资料.结果本组8例患者中胰源性肿瘤5例,腹膜后肿瘤3例.主要症状为上消化道出血和不规则左上腹疼痛.5例存在孤立性胃底静脉曲张,其他3例同时伴有食管下段静脉曲张.所有患者均接受了联合脏器切除,手术切除范围包括胰体尾、脾脏,部分病例还涉及胃、左肾、左肾上腺和结肠脾曲切除.随访期间无再出血病例,死亡1例,转移复发2例.结论肿瘤源性的区域性门静脉高压病例相对少见,积极地施行联合脏器切除并辅以断流是治疗此类病症的有效方法,预后相对满意.
목적 탐토좌상복악성종류소치적구역성문정맥고압적병인、림상특점화치료방법.방법 회고성분석2006년1월지2009년12월상해교통대학의학원부속서금의원수치해류종류원성구역성문정맥고압8례환자적림상자료.결과 본조8례환자중이원성종류5례,복막후종류3례.주요증상위상소화도출혈화불규칙좌상복동통.5례존재고립성위저정맥곡장,기타3례동시반유식관하단정맥곡장.소유환자균접수료연합장기절제,수술절제범위포괄이체미、비장,부분병례환섭급위、좌신、좌신상선화결장비곡절제.수방기간무재출혈병례,사망1례,전이복발2례.결론 종류원성적구역성문정맥고압병례상대소견,적겁지시행연합장기절제병보이단류시치료차류병증적유효방법,예후상대만의.
Objective To investigate the etiology, clinical characteristics, diagnosis and treatment of regional portal hypertension caused by left upper abdominal malignant tumors. Methods From January 2006 to December 2009, a total of 8 patients presenting regional portal hypertension were treated at our hospital, whose clinical data were analyzed retrospectively. Results Pancreatic tumors (5/8) and retroperitoneal tumors (3/8) were the primary etiology, and the main symptoms included upper gastrointestinal bleeding and irregular left upper abdominal pain. Isolated gastric varices were the most distinct clinical features. All patients underwent multi-visceral resection including pancreatic body and tail and spleen. Tumor involved stomach, left kidney, left adrenal and splenic flexure of colon were also removed en bloc. During the follow-up period there was no recurrent upper gastrointestinal bleeding, one patient died and two patients developed metastasis or tumor local recurrence. Conclusion Regional portal hypertension caused by malignant tumor was relatively rare, aggressive resection of multi-viscera combined with devascularization was an effective therapy.