Objective To evaluate the effects of combined splenorenal shunt with portoazygos devascularization for portal hypertension. MethodsA retrospective analysis of the clinical data of combined splenorenal shunt with portoazygos devascularization for portal hypertension in 58 cases was made. They were 41 male, 17 female and average age was 42.5 and posthepatitic liver cirrhosis in 51 cases, schistosomiasis cirrhosis in 7 cases, and Child A in 26 cases, B in 28, C in 4. There was selective operation in 39 cases (Child A 20, Child B 18, Child C 1), early operation in 10 (Child A 3, Child B 6, Child C 1) and emergency operation in 9 (Child A 3, Child B 4, Child C 2).ResultsAll but two (3.4%) Child C cases died after emergency operation, the others recovered. Esophagus varicoses disappeared or had a great improvement in all cases. There were liver function damage with different degree in 19 cases and subdiaphramatic effusion or infection or pleural effusion in 23 and all were cured by conservative therapy. Followed up for 5-10 years in 48 cases, there were rebleeding in 2 cases (3.5%) and postmeal encephalopathy in 2 (3.5%).ConclusionCombined splenorenal shunt and portoazygos devascularization are the first choice for portal hypertension at present.
目的探讨近端脾肾分流联合贲门周围血管离断术治疗肝硬变门脉高压症的疗效。方法回顾分析我院1994~2004年10年期间应用近端脾肾分流联合贲门周围血管离断术治疗62例肝硬变门脉高压病例。结果本组无手术死亡，随访56例，随访时间4~56个月，随访结果： 26例肝功能较前有所改善，49例静脉曲张明显减轻，无静脉破裂出血； 发生吻合口血栓5例，肝性脑病3例，因肝衰死亡3例。结论近端脾肾分流联合贲门周围血管离断术治疗肝硬变门脉高压症效果好，疗效满意。