CAJ | 학술논문

　　目的：探讨胰源性门静脉高压症的临床特点、诊断及外科治疗方法。方法：回顾性分析本院2002年1月-2012年6月收治的45例胰源性门静脉高压症患者的临床资料。结果：男32例，女13例，年龄31～68岁，平均年龄（43．5±6．4）岁。胰腺原发病为慢性胰腺炎27例（60．0％，其中合并胰腺假性囊肿12例）；胰体、尾部胰腺癌9例（20．0％）；胰腺无功能性胰岛细胞瘤2例（4．4％）；胰腺囊腺瘤3例（6．7％）；外伤后胰腺假性囊肿4例（8．9％）。45例患者均伴有胃、食管静脉曲张，其中孤立性胃静脉曲张42例，胃静脉合并食管下段静脉曲张3例。术前有呕血和（或）便血史者19例（42．2％），有上腹不适、疼痛等腹部症状者33例（73．3％），伴有脾功能亢进者41例（91．1％）。45例患者均行手术治疗，术后胰漏2例，门静脉血栓5例，无围手术期死亡。42例患者获得随访，所有患者术后均未再出现消化道出血。结论：胰源性门静脉高压症是一种特殊类型的门静脉高压症，胰腺原发疾病的治疗是其治疗的关键，手术治疗可获良好效果。
　　목적：탐토이원성문정맥고압증적림상특점、진단급외과치료방법。방법：회고성분석본원2002년1월-2012년6월수치적45례이원성문정맥고압증환자적림상자료。결과：남32례，녀13례，년령31～68세，평균년령（43．5±6．4）세。이선원발병위만성이선염27례（60．0％，기중합병이선가성낭종12례）；이체、미부이선암9례（20．0％）；이선무공능성이도세포류2례（4．4％）；이선낭선류3례（6．7％）；외상후이선가성낭종4례（8．9％）。45례환자균반유위、식관정맥곡장，기중고립성위정맥곡장42례，위정맥합병식관하단정맥곡장3례。술전유구혈화（혹）편혈사자19례（42．2％），유상복불괄、동통등복부증상자33례（73．3％），반유비공능항진자41례（91．1％）。45례환자균행수술치료，술후이루2례，문정맥혈전5례，무위수술기사망。42례환자획득수방，소유환자술후균미재출현소화도출혈。결론：이원성문정맥고압증시일충특수류형적문정맥고압증，이선원발질병적치료시기치료적관건，수술치료가획량호효과。
Objective :To explore the clinical characteristics ,diagnosis and surgical treatment of pancreatic sinistral portal hypertension(PSPH) .Methods :45 cases of PSPH treated in our hospital from January 2002 to June 2012 were analyzed retrospectively .Results:There were 32 males and 13 females ,aged from 31 to 68 years old .The primary pan-creatic disease was chronic pancreatitis in 27 patients (60 .0% ,of which 12 cases combined with pancreatic pseudo-cyst) ,pancreatic body and tail cancer in 9 cases (20 .0% ) ,non-functional islet cell tumors in 2 cases (4 .4% ) ,pancreatic cystadeno main 3 cases (6 .7% ) ,and pancreatic pseudocyst after trauma in 4 cases (8 .9% ) .All 45 patients developed gastro esophageal varices ,including 42 isolated gastric varices and 3 gastric varices incorporated with esophageal vari-ces .There were 19 patients have apre operative hematemesis and (or) hematochezia(42 .2% );33 cases have an upper abdominal discomfort ,pain or other abdominal symptoms (73 .3% );and 41 cases accompanied with hypersplenism (91.1% ) .All of the 45 patients underwent surgical treatment ,2 cases had pancreatic leakage after surgery ,and 5 cases had partial portal vein thrombosis after surgery ,no perioperative mortality .42 patients were followed-up ,no massive digestive tract re-bleeding occurred .Conclusion:PSPH is a special type of portal hypertension ;the key step is to cure the primary pancreatic disease ;surgical treatment can get excellent results .