门静脉海绵样变性的诊断和治疗.pdfVIP

· 24· 医药论坛杂志 2008年2月 第29卷 第3期 门静脉海绵样变性的诊断和治疗 李红伟，徐崇松，罗 威，彭江涛，刘兴涛 漯河市第一人民医院普外科 漯河市 462000 摘要 目的 探讨门静脉海绵样变性(cavernous transformation of portal vein，CTPV)的诊断和治疗措施。 方法 对11例门静脉海绵样变性住院患者的临床资料进行回顾性分析。结果 11例患者以上消化道出血和／ 或脾功能亢进为临床表现，彩色多普勒超声检查诊断率为90．9％(10／11)；11例患者共实施13例次手术，胃冠 状血管及其分支结扎(断流)术2例次，脾切除+断流+脾肾分流术5例次；脾切除+大网膜包肾术4例次；肠系 膜上静脉和下腔静脉分流术2例次，随访1—4年，行分流术者预后效果良好。结论 彩色多普勒超声对门静脉 海绵样性变有较高的诊断价值，断流加分流术是门静脉海绵样变性的首选治疗方法。 关键词 门静脉海绵样变性；门静脉高压；诊断 中图分类号：R654．3 文献标识码：B 文章编号：1672—3422(2008)03-0024-03 Diagnosis and Treatment of Portal Cavernous Transformation LI Hongwei，XU Chongsong，LUO Wei，et al Luohe the Fimt People~Hospital，Luohe 462000，China ABSTRACT Objective To explore the diagnosis and treatment of cavernous transformation of portal vein(CTPV)．Methods Retrospectively analyzing clinical data of 1 1 cases with cavernous transformation of portal vein．Results The primary signs and symptoms of 1 1 cases were upper diges— tive tract hemorrhage and splenomegaly．The rate of diagnosis of cavernous transformation of portal vein by color Doppler uhrasonography(US)was 90．9％(10／1 1)．Two patients underwent disconnection operation，five patients had splenectomy and disconnection and central splenorenal shunt，four patients had a distal splenorenal shunt，and two patients underwent mesocaval shunt between inferior vena cava and superior mesenteric vein．All patients were followed one to four years，Lii~re were no deaths or he— patic encephalopathy，and the effect of prognosis were wel1．Conclusion Color Doppler uhrasonogra— phy(US)has upper merit to the diagnosis of cavernous transformation of portal vein，the operation of disconnection and shunt is the first choice method to cavernous transformation of portal vein． KEY WO