CAJ | 학술논문

食管胃底静脉曲张破裂出血是门静脉高压症患者死亡的主要原因之一,其治疗手段已经从早期外科手术一枝独秀,变成现在内镜治疗、介入治疗和手术治疗百家争鸣.由于肝移植供肝短缺,断流术在今后相当长的一段时间内依然是我国治疗门静脉高压症的主要手段之一.北京大学人民医院肝胆外科结合自身经验对传统断流手术进行改进,提出保脾断流术.该技术具有术中出血量少,手术时间短,术后并发症发生率低等优势,取得了较好的近期和远期止血效果.
식관위저정맥곡장파렬출혈시문정맥고압증환자사망적주요원인지일,기치료수단이경종조기외과수술일지독수,변성현재내경치료、개입치료화수술치료백가쟁명.유우간이식공간단결,단류술재금후상당장적일단시간내의연시아국치료문정맥고압증적주요수단지일.북경대학인민의원간담외과결합자신경험대전통단류수술진행개진,제출보비단류술.해기술구유술중출혈량소,수술시간단,술후병발증발생솔저등우세,취득료교호적근기화원기지혈효과.
Gastroesophageal variceal bleeding is one of the major causes of death for patients with portal hypertension.The treatment of portal hypertension has evolved from surgery being the only option to the wide range of options currently available,including endoscopic sclerotherapy of varietals ligation,interventional radiology and surgery.Given the shortage of liver transplantation donors,devascularization would be one of the major treatments for portal hypertension for a considerable time.Based on the clinical experience of the People's Hospital of Peking University,we think that peraesophagogastric devascularization without splenectomy is a better option for the treatment of portal hypertension,with less operation time,less intraoperative blood loss and fewer postoperative complications,and better short-and long-term hemostatic effect.