【摘要】 目的评价内镜结扎、断流术与腔内外联合断流对门奇静脉侧支循环的影响。方法 115例患者随机分为内镜结扎组(54例)、断流手术组(30例)、腔内外联合断流组(31例),在治疗前后用微探头超声检查食管下段静脉,彩色多普勒超声检测奇静脉血流动力学各项指标。结果治疗后内镜结扎组食管静脉曲张消失但周围静脉侧支仍存在;断流组食管周围静脉侧支减少但静脉曲张无明显变化;联合组食管静脉曲张和周围静脉侧支均显著减少或消失。3组奇静脉血流量较术前分别下降31％、32％和43％。结论腔内外联合断流较单一的治疗方法能更好地阻断门奇静脉侧支血流。更多还原

【Abstract】 Objective To assess the effect of different treatment complex on portoazygous shunt in portal hypertensive patients. Methods Patients (115 cases) with esophageal varices were randomized to receive either endoscopic variceal ligation ( EVL) alone (54 cases ) , pericardial devascularization procedure (PDP) alone(30 cases) or a combination of EVL and PDP(31 cases) for variceal eradication. Esophageal vascular structures were examined with miniature ultrasonic probe and azygos blood flow (ABF) was measured with color Doppler ultrasonography. Results Esophageal varices were obliterated and collateral veins remained unchanged in patients treated by EVL, esophageal varices were diminished in size and collateral veins were obliterated by PDP and both esophageal varices and collateral veins were obliterated by the combination of EVL and PDP. EVL,PDP alone and a combination of the two modalities decreased ABF by 31% ,32% and 43% respectively. Conclusions The combination of EVL and PDP most effectively blocks esophageal collateral shunts.更多还原