肠腔静脉人工血管C型分流术的远期疗效观察
安东均，王超峰，马富平，张成
摘 要
目的：探讨肠腔静脉C型分流术治疗食管胃底静脉曲张破裂出血的远期疗效。
方法：对咸阳市中心医院肝胆外科1992年以来施行的36例肠腔静脉C型分流术的临床资料进行总结分析。
结果：36例患者术后门静脉压平均下降1.51 kPa，胃镜检查食管静脉曲张均有明显减轻或消失。术后再出血率5.6%，肝性脑病发生率8.3%，术后1年、3年、5年及10年的生存率分别为97.2%、93.3%、89.3%及66.7% 。
结论：肠腔静脉C型分流术手术适应证广，操作简单，近、远期疗效满意，适于推广。
关键词
门静脉；高血压；肠腔静脉分流术；外科手术；人工血管
Long-term therapeutic effect of the mesocaval C shunt with artifical blood vessel
AN Dongjun，WANG Chaofeng，MA Fuping，ZHANG Cheng（Department of Hepatobili-ary Surgery，The Xianyang Centred Hospital，Xianyang 712000，Shanxi，China）
ABSTRACT
Objective:To evaluate the long-term effectiveness of the mesocaval C shunt in the treatment of gastroesophageal varicosis rupture bleeding.
Methods:Clinical data of 36 cases with gastroesophageal varicosis bleeding performed mesocaval C shunt since 1992 were analyzed.
Results:Postoperative portal vein pressure in 36 cases were reduced by an average of 1.51 kPa（15.38 cm H2O）The gastroesophageal varicosis was alleviated in all patients in postoperative fibergastroscopic examination The rebleeding rate and postoperative hepatic encephalopathy occurrence rate were 5.6%and 8.3%respectively The postoperative survival rate in 1，3，5，10 years were 97.2% ，93.3% ，89.3% ，66.7%.
Conclusion:There is wide indication of mesocaval C shunt technique and it is easy to operate，satisfactory for short-term and long-term therapeutic effectness Thus this technique is suitable for spreading its application.
KEY WORDS
portal vein；hypertension；mesocaval shunt:surgical operation；artificial blood vessel
肠腔架桥分流术是治疗食管胃底静脉曲张破裂出血的一种较理想术式。Cameron［1］于1980年首先设计并报道肠系膜上静脉与下腔静脉人造血管C型架桥分流术，咸阳市中心医院肝胆外科1992年引进该术式用于临床以来，共完成手术36例，近、远期疗效满意，现报道如下。