| 邓富强,温哲.合并胡桃夹综合征的儿童肝内型门静脉高压行脾腔分流术 1例[J].安徽医药,2024,28(8):1633-1635. |
| 合并胡桃夹综合征的儿童肝内型门静脉高压行脾腔分流术 1例 |
| Splenic shunt performed on a child with intrahepatic portal hypertension complicated with nutcracker syndrome |
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| DOI：10.3969/j.issn.1009-6469.2024.08.031 |
| 中文关键词: 高血压，门静脉 肾胡桃夹综合征 儿童 肝内型 Warren手术 脾腔分流术 |
| 英文关键词: Hypertension,portal Renal nutcracker syndrome Children Intrahepatic type Warren surgery Splenoluminal shunt |
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| 中文摘要: |
| 目的探索儿童肝内型门静脉高压的手术治疗经验。方法总结 1例于 2022年 9月入住梅州市人民医院的儿童肝内型门静脉高压的病儿行远端脾 -下腔静脉分流的治疗方案选择。结果病儿主诉呕血 4h。术前诊断为门静脉高压，食管静脉重度曲张破裂出血。病儿入院后予对症治疗，病情稳定后拟行 Warren手术，术中发现肠系膜上动脉压迫左肾静脉并致其压力升高，故改行远端脾 -下腔静脉分流。术后随访 6个月，食管胃底静脉曲张减轻，脾亢改善，肝功能维持正常。结论儿童肝内型门静脉高压行选择性分流术时，在左肾静脉解剖异常或合并胡桃夹综合征，不能行 Warren手术的情况下，可以选择远端脾 下腔静脉分流术，也可达到选择性分流手术的效果。 |
| 英文摘要: |
| Objective To explore the surgical treatment of intrahepatic portal hypertension in children. Methods The choice of treatment with distal splenic-inferior vena cava shunt in a child with intrahepatic portal hypertension admitted to Meizhou People'sHospital in September 2022 was summarized.Results The child complained of hematemesis for 4 h. Preoperative diagnosis: portal hy-pertension, severe esophageal vein rupture and bleeding. After admission, the child was given symptomatic treatment. After the condi-tion was stable, Warren surgery was planned. During the operation, the superior mesenteric artery compressed the left renal vein andcaused the pressure to increase, so the distal splenic-inferior vena cava shunt was changed. At 6 months postoperative follow-up, esoph- agogastric varices decreased, hypersplenic improved and liver function remained normal. Conclusion When elective shunt is per- formed with intrahepatic portal hypertension, distal spleno-vena cava shunt can be selected when the left renal vein has abnormal anato- my or nutcracker syndrome and Warren surgery cannot be performed, and the effect of elective shunt surgery can also be achieved. |
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