CAJ | 학술논문

目的探讨联合分流和断流术治疗门静脉高压症的临床效果.方法对我院1990年5月至2008年5月采用联合分流和断流手术治疗的180例门静脉高压症病人的临床资料进行回顾性分析.结果术前自由门静脉压力(FPP)为32.5～35.5 cm H2O(1 cm H2O=0.098 kPa);脾切除、脾腔或肠腔分流术后FPP下降为24 cm H2O;联合手术后FPP平均为24.5 cm H2O.全组无手术死亡,125例随访6个月～7年,复发出血4例,肝性脑病4例,人造血管血栓形成4例,肝功能衰竭死亡2例.结论联合分流和断流术既保留了断流术的优点,又降低了门静脉的压力,是治疗门静脉高压症的理想术式之一.
목적 탐토연합분류화단류술치료문정맥고압증적림상효과.방법 대아원1990년5월지2008년5월채용연합분류화단류수술치료적180례문정맥고압증병인적림상자료진행회고성분석.결과 술전자유문정맥압력(FPP)위32.5～35.5 cm H2O(1 cm H2O=0.098 kPa);비절제、비강혹장강분류술후FPP하강위24 cm H2O;연합수술후FPP평균위24.5 cm H2O.전조무수술사망,125례수방6개월～7년,복발출혈4례,간성뇌병4례,인조혈관혈전형성4례,간공능쇠갈사망2례.결론 연합분류화단류술기보류료단류술적우점,우강저료문정맥적압력,시치료문정맥고압증적이상술식지일.
Objective To explore the therapeutic effect of combined splenocaval or mesocaval C shunt and portoazygous deverscularization for the treatment of portal hypertension. Methods The clinical datas of 180 cases of portal hypertension treated with combined procedures from May 1990 to May 2008 in our hospital were analyzed retrospectively. Results The mean free portal pressure was 32.5 -35.5 cm H2O before operation,24 cm H2O and 24.5 cm H2O after splenectomy plus splenocaval or mesocaval C shunt and combined procedure, respectively. There was no death in all patient,6 months - 7 years follow - up of 125 cases showed that 4 cases with rebleeding,4 cases with encephalopathy,4 cases with thrombosis in artificial vascular graft and 2 cases died of liver failure. Conclusions Combined shunt and portoazygous deverscularization not only decreases portal pressure but preserve hepatic blood flow to some extent, it' s one of the best choices for treating portal hypertension.