【作者】 陈金金；

【导师】 厉有名；

【作者基本信息】 浙江大学 ， 内科学， 2008， 硕士

【摘要】 目的:通过对收集的17例门静脉海绵样变病例的分析,探讨门静脉海绵样变(CTPV)的临床特点、诊断方法及治疗。方法:对浙一医院2000年1月—2008年4月经影像学诊断或手术确诊的17例门静脉海绵样变患者的病因、临床表现、实验室检查、影像学检查、治疗及预后进行回顾性分析。结果:17例患者病因不一且多不明确,7例考虑原发性可能大,4例患者存在血栓状态,1例存在乙肝肝硬化;17例多以首次或反复呕血黑便、脾脏肿大、脾功能亢进、腹胀腹痛为主要就诊症状;肝功能检查多正常,部分患者血常规示一定程度的单系或三系降低。多数患者同时行超声检查、CT、MRI等检查,各种检查的诊断率基本达100%,且各种检查之间符合率100%。11例患者进行手术治疗,主要术式为肠腔分流术、贲门周围血管离断术,脾亢患者均同时行脾切除术。对17例患者均成功进行了随访,除1例手术患者再次复发出血外,另10例手术患者术后情况均稳定。结论:门静脉海绵样变分为原发性和继发性两类,临床表现主要以继发性门脉高压为主,如消化道出血、脾肿大、脾亢等,超声检查多能初步确诊,外科手术是其主要治疗方法,主要术式有脾切除、断流、分流术等。更多还原

【Abstract】 Objective: According to the total 17 cases cavernous transformation of portal vein(CTPV),discuss the clinical characteristics, diagnostic methods and treatment of cavernous transformation of portal vein. Methods: A retrospective research was done in 17 patients with CTPV. visiting to The first affiliated hospital of ZheJiang University from January,2000 to April,2008.Result:The etiology of 17 patients is different and indefinite. The chief complain were firstly or repeated haematemesis, hemafecia, hypersplenotrophy, hypersplenia, abdominal distension and abdominal pain. All patient can be detected by ultrasonograph or CT or MRI. 11 patients were treated by operation, like splenectomy, by-pass technique or disconnection. All patients were fellow up ,most patients’have good general state of health after operation except one rehaematemesis. Conclusion CTPV is a kind of disease with unknown etiology, the clinical manifestation of which is secondary portal hypertension. Most cases could be detected by ultrasonography, and surgical operation is the main and best choice to cure CTPV.更多还原