摘要
探讨成人门静脉海绵状变性 (PVCT)的诊断和治疗。方法 对 15例成人PVCT的临床资料进行回顾性分析。结果 所有病人术前均经B超或多普勒超声检查提示肝脏正常及PVCT ,并经经皮脾穿刺门静脉造影或选择性肠系膜上动脉造影确诊。 9例行脾动脉结扎、冠状静脉结扎、肠系膜上静脉与下腔静脉C型架桥术 (肠腔C型架桥 ) ;1例行脾动脉结扎、脾肾静脉C型架桥术 ;5例已行脾切除加断流术后再出血者 ,4例行肠腔C型架桥术 ,1例因静脉曲张和出血部位在空肠而行空肠节段切除术。随访 3～ 18个月 ,食管胃底曲张静脉减轻或消失 ,无再出血和肝性脑病发生。结论 多普勒超声和经皮脾穿刺门静脉造影是诊断本病的理想方法 。
Objective To study the diagnosis and treatment of portal vein cavernous transformation (PVCT) in adults. Methods A retrospective study was made on clinical data of 15 adult patients with PVCT. Results The diagnosis of PVCT in 15 pitients were all comfirmed by B ultrasonography or ultrasonic Doppler and by percutaneous splenoportography or selective arteriography of superior mesenteric atrery. Of them, the liver was all normal. Nine patients underwent ligation of both splenic artery and coronary vein as well as mesocaval shunt with atrificial graft. Of 5 cases rebleeding after splenectomy and devascularization, 4 received C type mesocaval shunt and 1 received jejunectomy due to variceal hemorrhage within the jejunum. All of the 15 patients were followed up for 3～18months, the results demonstraated that reduction or disappearance of gastroesophageal varices and no rebleeding or hepatoencephalopathy occurred. Conclusions Ultrasounic Doppler and percutaneous slenoportography are effective to diagnose of PVCT in adults, while portal systemic shunt plus porta azygous devascularization is the best choice of treatment.
出处
《中国普通外科杂志》
CAS
CSCD
2000年第3期252-254,共3页
China Journal of General Surgery
关键词
高血压
门静脉
门静脉造影术
食管和胃静脉曲张
CAVERNOUS TRANSFORMATION OF PORTAL VEIN/diag
CAVERNOUS TRANSFORMATION OF PORTAL VEIN/surg
STUDY,RETROSPECTIVE
