胰源性門靜脈高壓癥并上消化道出血的診治體會_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

趙欣 ,  雷澤華 , 高峰畏 , 烏建平 , 付金強 , 杜波 , 王志旭 , 蔣康怡 , 謝青云

樂山市人民醫院肝膽胰脾外科（四川樂山 614000）;

Corresponding?author：

雷澤華, Email: leitsehua@126.com

Keywords：

門靜脈高壓癥; 胰源性; 上消化道出血; 脾切除

DOI：

10.7507/1007-9424.201809055

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的探討胰源性門靜脈高壓癥并上消化道出血的診斷及治療方式。方法回顧性分析 2014 年6 月至 2018 年 6 月期間筆者所在醫院診治的 13 例胰源性門靜脈高壓癥并上消化道出血患者的臨床資料。結果 2 例早期行內鏡下治療，因再發上消化道出血行手術治療；11 例早期明確診斷后行手術治療。所有行手術治療的患者術后恢復順利，無并發癥發生。術后均獲訪，隨訪時間 6～24 個月，中位數為 18 個月，隨訪期間無患者死亡及失訪病例，未再發消化道出血等并發癥。定期復查胃鏡及腹部 CT 檢查，曲張胃底靜脈情況明顯改善。結論對胰源性門靜脈高壓癥并上消化道出血患者，早期明確診斷是關鍵，應選擇針對胰腺疾病的相應手術治療方案。脾切除術聯合胃底血管離斷術是治療胰源性門靜脈高壓癥并上消化道出血的有效手術方式。

Citation： 趙欣, 雷澤華, 高峰畏, 烏建平, 付金強, 杜波, 王志旭, 蔣康怡, 謝青云. 胰源性門靜脈高壓癥并上消化道出血的診治體會. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(3): 348-350. doi: 10.7507/1007-9424.201809055 Copy

1.	李曉斌, 廖泉, 趙玉沛. 區域性門靜脈高壓癥的治療策略. 中國普外基礎與臨床雜志, 2015, 22(11): 1300-1301.
2.	Gyoten K, Mizuno S, Nagata M, et al. Significance of simultaneous splenic artery resection in left-sided portal hypertension after pancreaticoduodenectomy with combined portal vein resection. World J Surg, 2017, 41(8): 2111-2120.
3.	Lu HM, Lu S, Zhang L, et al. Left-sided portal hypertension associated with acute pancreatitis treated by splenectomy : clinical characteristics and outcomes in a cohort of 79 cases. Pancreatology, 2017, 17(4): S60.
4.	倪曉凌, 顧大鏞, 胡國華. 胰源性左側門脈高壓癥的外科治療及文獻復習. 中華肝膽外科雜志, 2015, 21(5): 342-343.
5.	Piero C, Luca S, Mario C, et al. Severe intestinal bleeding due to left-sided portal hypertension after pancreatoduodenectomy with portal resection and splenic vein ligation. MOJ Tumor Res, 2017, 1(1): 1-3.
6.	Chen BC, Wang HH, Lin YC, et al. Isolated gastric variceal bleeding caused by splenic lymphoma-associated splenic vein occlusion. World J Gastroenterol, 2013, 19(40): 6939-6942.
7.	Barge JU, Lopera JE. Vascular complications of pancreatitis: role of interventional therapy. Korean J Radiol, 2012, 13 Suppl 1: S45-S55.
8.	王曉偉. 介入治療老年胰源性門脈高壓癥患者并發消化道出血的臨床價值. 世界華人消化雜志, 2018, 26(6): 401-405.
9.	盧山, 陸慧敏, 張凌, 等. 胰腺假性囊腫致左側門靜脈高壓伴脾臟功能亢進的處理策略探討. 中國普外基礎與臨床雜志, 2018, 25(5): 553-558.
10.	柳健, 譚詩云, 李明. 左側門脈高壓癥的臨床及超聲內鏡特征分析. 廣西醫學, 2017, 39(1): 78-80.
11.	湯善宏, 范泉水. 內鏡下組織膠注射治療區域性門靜脈高壓致胃底靜脈曲張出血的療效分析. 臨床肝膽病雜志, 2015, 31(8): 1283-1286.
12.	Gandini R, Merolla S, Chegai F, et al. Trans-splenic embolization plus partial splenic embolization for management of variceal bleeding due to left-sided portal hypertension. Dig Dis Sci, 2018, 63(1): 264-267.
13.	Cortes A, Kim J, Commander C, et al. Splenic artery embolization for the treatment of gastric variceal bleeding secondary to splenic vein thrombosis. J Vas Interventional Rad, 2018, 29(4): S13-S14.
14.	Butler JR, Eckert GJ, Zyromski NJ, et al. Natural history of pancreatitis-induced splenic vein thrombosis: a systematic review and meta-analysis of its incidence and rate of gastrointestinal bleeding. HPB (Oxford), 2011, 13(12): 839-845.
15.	王要軒, 姜青峰, 李珂, 等. 胰源性門靜脈高壓 37 例臨床分析. 中華肝膽外科雜志, 2017, 23(2): 114-116.

1. 李曉斌, 廖泉, 趙玉沛. 區域性門靜脈高壓癥的治療策略. 中國普外基礎與臨床雜志, 2015, 22(11): 1300-1301.
2. Gyoten K, Mizuno S, Nagata M, et al. Significance of simultaneous splenic artery resection in left-sided portal hypertension after pancreaticoduodenectomy with combined portal vein resection. World J Surg, 2017, 41(8): 2111-2120.
3. Lu HM, Lu S, Zhang L, et al. Left-sided portal hypertension associated with acute pancreatitis treated by splenectomy : clinical characteristics and outcomes in a cohort of 79 cases. Pancreatology, 2017, 17(4): S60.
4. 倪曉凌, 顧大鏞, 胡國華. 胰源性左側門脈高壓癥的外科治療及文獻復習. 中華肝膽外科雜志, 2015, 21(5): 342-343.
5. Piero C, Luca S, Mario C, et al. Severe intestinal bleeding due to left-sided portal hypertension after pancreatoduodenectomy with portal resection and splenic vein ligation. MOJ Tumor Res, 2017, 1(1): 1-3.
6. Chen BC, Wang HH, Lin YC, et al. Isolated gastric variceal bleeding caused by splenic lymphoma-associated splenic vein occlusion. World J Gastroenterol, 2013, 19(40): 6939-6942.
7. Barge JU, Lopera JE. Vascular complications of pancreatitis: role of interventional therapy. Korean J Radiol, 2012, 13 Suppl 1: S45-S55.
8. 王曉偉. 介入治療老年胰源性門脈高壓癥患者并發消化道出血的臨床價值. 世界華人消化雜志, 2018, 26(6): 401-405.
9. 盧山, 陸慧敏, 張凌, 等. 胰腺假性囊腫致左側門靜脈高壓伴脾臟功能亢進的處理策略探討. 中國普外基礎與臨床雜志, 2018, 25(5): 553-558.
10. 柳健, 譚詩云, 李明. 左側門脈高壓癥的臨床及超聲內鏡特征分析. 廣西醫學, 2017, 39(1): 78-80.
11. 湯善宏, 范泉水. 內鏡下組織膠注射治療區域性門靜脈高壓致胃底靜脈曲張出血的療效分析. 臨床肝膽病雜志, 2015, 31(8): 1283-1286.
12. Gandini R, Merolla S, Chegai F, et al. Trans-splenic embolization plus partial splenic embolization for management of variceal bleeding due to left-sided portal hypertension. Dig Dis Sci, 2018, 63(1): 264-267.
13. Cortes A, Kim J, Commander C, et al. Splenic artery embolization for the treatment of gastric variceal bleeding secondary to splenic vein thrombosis. J Vas Interventional Rad, 2018, 29(4): S13-S14.
14. Butler JR, Eckert GJ, Zyromski NJ, et al. Natural history of pancreatitis-induced splenic vein thrombosis: a systematic review and meta-analysis of its incidence and rate of gastrointestinal bleeding. HPB (Oxford), 2011, 13(12): 839-845.
15. 王要軒, 姜青峰, 李珂, 等. 胰源性門靜脈高壓 37 例臨床分析. 中華肝膽外科雜志, 2017, 23(2): 114-116.

Previous Article
乳腺包裹性乳頭狀癌 3 例報道并文獻復習
Next Article
Application of functional MRI in assessment of hepatic warm ischemia-reperfusion injury

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

胰源性門靜脈高壓癥并上消化道出血的診治體會

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content