CAJ | 학술논문

目的探讨联合部分断流的冠腔分流术治疗门脉高压上消化道出血的近期和远期疗效.方法对11例门静脉高压症患者施行联合部分断流的冠腔分流术,其中移植血管采用自身脾静脉的6例,冠状静脉与下腔静脉直接吻合的5例.结果本组11例患者手术均获得成功,无手术死亡和近期再出血.随访5个月至11年,平均随访5年3个月,死亡2例,无再出血,无肝性脑病.结论冠腔分流属于高选择性门腔分流术.联合部分断流的冠腔分流不仅区域性降压效果显著,且能保证门静脉的入肝血流,减少再出血和肝性脑病的发生率.
목적 탐토연합부분단류적관강분류술치료문맥고압상소화도출혈적근기화원기료효.방법 대11례문정맥고압증환자시행연합부분단류적관강분류술,기중이식혈관채용자신비정맥적6례,관상정맥여하강정맥직접문합적5례.결과 본조11례환자수술균획득성공,무수술사망화근기재출혈.수방5개월지11년,평균수방5년3개월,사망2례,무재출혈,무간성뇌병.결론 관강분류속우고선택성문강분류술.연합부분단류적관강분류불부구역성강압효과현저,차능보증문정맥적입간혈류,감소재출혈화간성뇌병적발생솔.
Objective To investigate the short-term and long-term effect of cornary-caval shunt accompanied by pericardial devascularization in the treatment of upper gastrointestinal bleeding caused by portal hypertension.Methods Eleven patients with portal hypertension underwent cornary-caval shunt accompanied by partial pericardial devascularization were chosen.Of the 11 patients 6 applied autogenous splenic veins for graft and in 5 cases the coronary vein and inferior vena cava were anastomosed directly.Results Of the 11 patients,no operative mortality or early rebleeding.All patients were followed up from 5 months to 11 years with an average of 5 years and 3 months,of whom two died,others having no rebleeding or hepatic encephalopathy.Conclusion Cornary-caval shunt is a highly selective portosystemic shunt.Cornary-caval shunt accompanied by pericardial devascularization is a surgical treatment of upper gastrointestinal bleeding caused by portal hypertension for its apparent regional antihypertensive effect,the normal blood flow of liver,and reduction of the incidence of rebleeding.