门系统分流术控制肝硬化患者静脉曲张出血:过去和现在。

IF 2.7 4区 医学 Q2 Medicine Canadian Journal of Gastroenterology and Hepatology Pub Date : 2022-09-17 eCollection Date: 2022-01-01 DOI:10.1155/2022/1382556
Petre Radu, Virgiliu-Mihail Prunoiu, Victor Strâmbu, Dragos Garofil, Roxana Elena Doncu, Eugen Brătucu, Laurentiu Simion, Maria-Manuela Răvaş, Mircea Nicolae Brătucu
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引用次数: 2

摘要

基于50多年治疗门静脉高压症(PHT)的经验,作者回顾并分析了外科门静脉分流术(PCS)的发展。我们想提供一个深入了解过去的PCS,以便将其与目前治疗PHT并发症的状态进行比较。作为过去的一个里程碑,我们将介绍在1968年至1983年期间进行的500多个PHT病例的统计数据。在这一组中,在15年期间,238例患者接受了外科门静脉分流术。我们研究了PCS术后门静脉血流动力学的行为,并记录了门静脉压力(PP)的下降和残余PP。门静脉压力测定采用Hellige装置进行电子记录,术中通过门静脉分支导管直接记录。PCS在血流动力学效率方面与肝内分流术(tips -经颈静脉肝内门静脉分流术)的结果是重叠的。作者讨论了pc的现状,与50年前的情况相比,pc的情况明显下降。目前控制静脉曲张出血的方法取得了明显的进展。在其他治疗方法失败或不推荐的特定情况下,PCS的适应症非常有限。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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The Portosystemic Shunt for the Control of Variceal Bleeding in Cirrhotic Patients: Past and Present.

Based on an experience of more than 50 years in the treatment of portal hypertension (PHT), the authors review and analyze the evolution of the surgical portocaval shunt (PCS). We would like to provide an insight into the past of PCS, in order to compare it with the current state of the treatment of PHT complications. As a landmark of the past, we shall present statistics of more than 500 cases of PHT operated between 1968 and 1983. From this group, 238 patients underwent surgical portocaval shunting during a fifteen-year period. The behavior of the portal hemodynamics following PCS was studied and the postoperative decrease in portal pressure (PP), as well as the residual PP, were recorded. The portal manometric determinations were made by electronic recordings using the Hellige device and direct intraoperative recordings through the catheterization of a ramus in the portal area. The results of PCS are superposable, in terms of hemodynamic efficiency, with those of the intrahepatic shunt (TIPS-transjugular intrahepatic portosystemic shunt). The authors discuss the current place of PCS, in obvious decline in comparison with the situation 50 years ago. The current methods of controlling variceal bleeding represent obvious progress. PCS remains with very limited indications, in specific situations when the other therapeutic methods have failed or are not recommended.

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来源期刊
CiteScore
4.80
自引率
0.00%
发文量
0
审稿时长
37 weeks
期刊介绍: Canadian Journal of Gastroenterology and Hepatology is a peer-reviewed, open access journal that publishes original research articles, review articles, and clinical studies in all areas of gastroenterology and liver disease - medicine and surgery. The Canadian Journal of Gastroenterology and Hepatology is sponsored by the Canadian Association of Gastroenterology and the Canadian Association for the Study of the Liver.
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