CAJ | 학술논문

　　目的探讨区域性门静脉高压症的临床特点及治疗。方法回顾性分析解放军总医院2008年1月-2012年6月收治的45例确诊为区域性门静脉高压症患者的病例资料。结果引起区域性门静脉高压症的病因主要为胰源性因素(39例86.7%)，其他因素相对较少(6例13.3%)。本病临床表现包括原发病、消化道出血及脾大脾亢等，而肝功能均正常。腹部超声、CT/MRI、血管造影、胃镜、钡餐造影等辅助检查结合术中探查有助于确诊。21例接受内镜下注射组织胶栓塞治疗；21例行脾切除+贲门胃底周围血管离断术，2例行单纯脾切除术。外科治疗效果较为满意，短期、长期随访疗效均好于内镜下治疗。结论依脾切除并根据曲张静脉情况行贲门周围血管离断术治疗区域性门静脉高压症疗效肯定。
　　목적탐토구역성문정맥고압증적림상특점급치료。방법회고성분석해방군총의원2008년1월-2012년6월수치적45례학진위구역성문정맥고압증환자적병례자료。결과인기구역성문정맥고압증적병인주요위이원성인소(39례86.7%)，기타인소상대교소(6례13.3%)。본병림상표현포괄원발병、소화도출혈급비대비항등，이간공능균정상。복부초성、CT/MRI、혈관조영、위경、패찬조영등보조검사결합술중탐사유조우학진。21례접수내경하주사조직효전새치료；21례행비절제+분문위저주위혈관리단술，2례행단순비절제술。외과치료효과교위만의，단기、장기수방료효균호우내경하치료。결론의비절제병근거곡장정맥정황행분문주위혈관리단술치료구역성문정맥고압증료효긍정。
Objective To study the clinical features and treatment of regional portal hypertension (RPH). Methods Clinical data about 45 RPH patients admitted to our hospital from January 2008 to June 2012 were retrospectively analyzed. Results Of the 45 patients included in this analysis, 39 (86.7%) were diagnosed with RPH which was resulted from pancreatic diseases and 6 (13.3%) were diagnosed with RPH which was resulted from non- pancreatic diseases. The patients were manifested as primary disease, gastrointestinal bleeding, splenomegaly, hyperslenism, and normal liver function. Abdominal ultrasonography, CT, MRI, angiography, gastroscopy, barium contrast radiography, and intraoperative exploration contributed to the diagnosis of RPH. Of the 45 patients, 21 underwent endoscopic injection with tissue adhesive, 21 splenectomy combined with pericardia devascularization, and 2 splenectomy only. The short-and long-term outcomes of surgery were better than those of endoscopic treatment. Conclusion The diagnosis of RPH can be established according to its medical history, clinical features and auxiliary examination. Splenectomy plus pericardia devascularization is the first treatment of choice for RPH.