中国实用外科杂志

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   

  1. 北京大学人民医院外科， 北京100044
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-05-13 发布日期:2009-05-13

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-05-13 Published:2009-05-13

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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。

关键词: 肝移植, 门静脉高压症

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

Key words: liver transplantation, portal hypertension