肝胆外科-门脉高压症（教学）医学课件.ppt

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TreatmentofVaricealbleeding非手术治疗expectanttreatment输血bleedtransfusion生长抑素Sandostatin三腔二囊管压迫内镜套扎

endoscopicesophagealvaricealligation硬化剂注射endoscopicesophagealvaricealsclerotherapy食道静脉曲张破裂出血的手术治疗

Surgicaltreatment

分流术shuntoperation断流术devascularizationoperation经颈静脉肝内门腔支架分流术

Transjugularintrahepaticportosystemicstentshunt,TIPS门腔分流术portocavalshuntoperation部分门腔分流术

partialportacavalshuntoperation肠腔分流术

mesocavaloperation选择性远端脾肾静脉分流术Warrenoperation断流术devascularizationoperation内镜及药物处理失败后的食道静脉曲张破裂出血的手术处理方案2.脾亢的外科治疗

脾切除术或脾切除+断流术3.腹水的外科治疗腹腔静脉转流术TIPS肝移植4.终末期肝病的根治性处理方案

--livertransplantation手术步骤器官修整病肝切除供肝植入切除的病肝良好的肝移植效果肝癌和胆汁淤积性肝硬化患者原发性胆汁淤积症患者肝移植术后其它各类疾病患者肝移植术后状态再次肝移植我中心开展的腹部联合器官移植肝肾联合移植肝胰联合移植（省内首例，国内第二例）胰肾联合移植（省内首位成功病例）（省内首例）第二节肝前型门脉高压症

Prehepaticportalhypertension病因etiology先天畸形congenitalmalformation脐静脉炎omphalophlebitis门静脉海绵样变cavernoustransformationofportalvein动静脉瘘A-Vfistula肝前型门脉高压症

Prehepaticportalhypertension临床表现clinicalmanifestation处理treatment第三节肝后型门脉高压症

Budd-ChiariSyndromeTheBudd-Chiarisyndromeiscausedbyhepaticvenousobstruction.Theobstructionmayoccurattheleveloftheinferiorvenacava,thehepaticveins,orthecentralveinswithintheliveritself.病因

Etiologycongenitalwebs(mostcommoninAfricaandAsia),acute/chronicthrombosis(mostcommonintheWest):hypercoagulablestatesassociatedwithpolycythemiavera,myeloproliferativedisorders,paroxysmalnocturnalhemoglobinuria,anddefectsinthecoagulationcascade,asinconditionsassociatedwithhighestrogen