肝移植时代门静脉高压症治疗策略

冷希圣

中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (05) : 373-376.

PDF(442 KB)
PDF(442 KB)
中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (05) : 373-376.
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肝移植时代门静脉高压症治疗策略

  • 冷希圣
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摘要

门静脉高压症病人肝移植手术的适应证为:(1)伴有肝功能失代偿的门静脉高压症上消化道大出血或反复出血者;(2)反复发生的自发性肝性脑病;(3)顽固腹水,内科治疗不能控制者。对有上消化道出血史者尤其是肝功能较差者,应大力强调应用非选择性β受体阻滞剂及规范的内镜下套扎治疗。应强调规范的、精确断流手术在肝硬化门静脉高压症外科治疗中的地位。

Abstract

Management of portal hypertension in an era of liver transplantation LENG Xi-sheng. Department of Surgery, Peking University People's Hospital, Beijing 100044,China Abstract The indications of patients with cirrhotic portal hypertension for liver transplantation could be summarized as: (1)Massive upper GI bleeding in a portal hypertensive patient complicated by liver disfunctions. (2) Recurrent spontaneous hepatic encephalopathy. (3)Intractable hepatic ascites.It should be emphasized that nonselective β-receptor blockers and esophageal varix ligatian should always be attempted in patients suffering from upper GI bleeding especially in those with compromised liver functions. Refined and pin-point gastroesophageal devascularization emphasizing the integrity of coronal and paraesophageal veins is effective in the prevention of recurrent bleeding as well as deterioration of liver functions

关键词

肝移植 / 门静脉高压症

Key words

liver transplantation / portal hypertension

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冷希圣. 肝移植时代门静脉高压症治疗策略[J]. 中国实用外科杂志. 2009, 29(05): 373-376

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