• 昆明市第一人民醫(yī)院暨昆明醫(yī)學(xué)院附屬甘美醫(yī)院肝移植中心(昆明650011);

目的  介紹門靜脈海綿樣變性外科治療的研究進(jìn)展。方法  收集國內(nèi)、外近年來有關(guān)門靜脈海綿樣變性治療的研究進(jìn)展的文獻(xiàn)并作一綜述。 結(jié)果  大多數(shù)門靜脈海綿樣變性患者以反復(fù)嘔血、便血，脾腫大，脾功能亢進(jìn)為主要癥狀。大多數(shù)患者通過超聲檢查或者門靜脈造影可以確診。手術(shù)治療多采取脾切除、分流術(shù)加斷流術(shù)。結(jié)論  門靜脈海綿樣變性的外科治療具有廣闊的發(fā)展前景。

引用本文： 王欣博,童中勛,劉威,李立. 門靜脈海綿樣變性外科治療的研究進(jìn)展. 中國普外基礎(chǔ)與臨床雜志, 2008, 15(12): 877-879. doi: 復(fù)制

1. 蔣小云, 陳述枚. 門靜脈海綿樣變性的診療進(jìn)展 [J]. 國外醫(yī)學(xué)·兒科學(xué)分冊(cè), 1999; 26(3)∶128.
2. 馮子毅, 劉 磊, 夏 培， 等. 小兒門靜脈海綿樣變性的分型及手術(shù)方式選擇的探討 [J]. 中國現(xiàn)代醫(yī)學(xué)雜志, 2004; 14（8）∶114.
3. Karagulle E, Turk E, Gokturk HS, et al. Prothrombin 20210 G/A defect as a cause of mesenteric venous infarction: report of a case [J]. Surg Today, 2007; 37(3)∶251.
4. Hwang S, Moon KM, Park JI, et al. Retroduodenal resection of ampullary carcinoid tumor in a patient with cavernous transformation of the portal vein [J]. J Gastrointest Surg, 2007; 11(10)∶1322.
5. Ohnishi K, Okuda K, Ohtsuki T, et al. Formation of hilar collaterals or cavernous transformation after portal vein obstruction by hepatocellular carcinoma. Observations in ten patients [J]. Gastroenterology, 1984; 87(5)∶1150.
6. Gonen C, Akarsu M, Solmaz D, et al. Hodgkin’s disease presenting with chylous ascites and cavernous transformation of the portal vein [J]. Dig Dis Sci, 2007; 52(12)∶3511.
7. Lupescu I, Masala N, Capsa R, et al. CT and MRI of acquired portal venous system anomalies [J]. J Gastrointestin Liver Dis, 2006; 15(4)∶393.
8. 方馳華, 項(xiàng) 楠, 范應(yīng)方, 等. 64層螺旋CT三維成像在消化系統(tǒng)疾病診治中的臨床應(yīng)用價(jià)值 [J]. 中華外科雜志, 2007; 45(13)∶909.
9. 齊立行, 杜國元, 陳佛來. 門靜脈海綿樣變(附2例報(bào)告) [J]. 中國實(shí)用外科雜志， 1998; 18（8）∶480.
10. Frutos Bernal MD, Fernández Hernández JA, Carrasco Prats M, et al. Portal-splenic-mesenteric venous thrombosis secondary to a mutation of the prothrombin gene [J]. Gastroenterol Hepatol, 2005; 28(6)∶329.
11. Miniati DN, Padidar AM, Kee ST, et al. Portal vein thrombosis after laparoscopic splenectomy: an ongoing clinical challenge [J]. JSLS, 2005; 9(3)∶335.
12. 楊 鎮(zhèn), 劉飛龍, 戴植本, 等. 賁門周圍血管離斷術(shù)治療門靜脈高壓癥的療效分析 [J]. 中華普通外科雜志, 1998; 13(2)∶74.
13. 楊 靈, 肖渝清, 陳矢明, 等. 門靜脈海綿樣變的手術(shù)治療 [J]. 腹部外科, 2003； 16(2)∶118.
14. Matsumoto H, Suzuki F, Souda K, et al. Improved long-term survival following complete eradication of esophageal varices by sclerotherapy [J]. Hepatogastroenterology, 1999; 46(25)∶172.
15. 曹 農(nóng), 俞永江, 柴 琛, 等. 門靜脈高壓癥外科治療185例 [J]. 肝膽胰外科雜志, 2008; 20(4)∶286.
16. Condino AA, Ivy DD, O’Connor JA, et al. Portopulmonary hypertension in pediatric patients [J]. J Pediatr, 2005; 147(1)∶20.
17. Warren WD, Henderson JM, Millikan WJ, et al. Management of variceal bleeding in patients with noncirrhotic portal vein thrombosis [J]. Ann Surg, 1988; 207(5)∶623.
18. Bambini DA, Superina R, Almond PS, et al. Experience with the Rex shunt (mesenterico-left portal bypass) in children with extrahepatic portal hypertension [J]. J Pediatr Surg, 2000; 35(1)∶13.
19. Wax JR, Pinette MG, Cartin A, et al. Cavernous transformation of the portal vein complicating pregnancy [J]. Obstet Gynecol, 2006; 108(3 Pt 2)∶782.
20. 趙龍栓, 范應(yīng)中, 許培欽. 改良脾肺固定術(shù)治療門靜脈海綿樣變性 [J]. 中國綜合臨床, 2003; 19(10)∶950.
21. 肖渝清, 胡先典. 門靜脈海綿樣變的手術(shù)治療 [J]. 中華肝膽外科雜志, 2003; 9（10）∶625.
22. Walser EM, Soloway R, Raza SA, et al. Transjugular portosystemic shunt in chronic portal vein occlusion: importance of segmental portal hypertension in cavernous transformation of the portal vein [J]. J Vasc Interv Radiol, 2006; 17(2 Pt 1)∶373.
23. Senzolo M, Tibbals J, Cholongitas E, et al. Transjugular intrahepatic portosystemic shunt for portal vein thrombosis with and without cavernous transformation [J]. Aliment Pharmacol Ther, 2006; 23(6)∶767.
24. 李德宇. 門靜脈海綿樣變性的外科診斷與治療 [J]. 實(shí)用兒科臨床雜志, 2005; 20(8)∶812.
25. 熊毅敏, 徐維田, 王一鳴， 等. 門靜脈海綿樣變性11例臨床分析 [J]. 實(shí)用醫(yī)學(xué)雜志, 2005; 21(5)∶484.
26. 宋軍民, 田 豐, 李 巖， 等. 門靜脈海綿樣變性10例臨床分析 [J]. 遼寧醫(yī)學(xué)雜志, 2004; 18(2)∶93.
27. 曠歷瓊. 門靜脈海綿樣變性7例臨床分析 [J]. 現(xiàn)代中西醫(yī)結(jié)合雜志, 2007; 16（34）∶5109.
28. 花 榮, 孫勇偉, 吳志勇. 聯(lián)合手術(shù)治療兒童門靜脈海綿樣變性肝前性門靜脈高壓癥 [J]. 肝膽外科雜志, 2005; 13（6）∶428.
29. 張明滿, 金先慶, 嚴(yán)律南, 等. 親體肝移植治療兒童門靜脈海綿樣變性3例臨床分析　[J]. 中華肝臟病雜志, 2008; 16(4)∶270.
30. Hajdu CH, Murakami T, Diflo T, et al. Intrahepatic portal cavernoma as an indication for liver transplantation [J]. Liver Transpl, 2007; 13(9)∶1312.
31. Silva MA, Jambulingam PS, Gunson BK, et al. Hepatic artery thrombosis following orthotopic liver transplantation: a 10-year experience from a single centre in the United Kingdom [J]. Liver Transpl, 2006; 12(1)∶146.
32. Bauer J, Johnson S, Durham J, et al. The role of TIPS for portal vein patency in liver transplant patients with portal vein thrombosis [J]. Liver Transpl, 2006; 12(10)∶1544.
33. 王 俊, 蔡 威, 潘偉華， 等. 肝移植治療小兒先天性門靜脈海綿樣變 [J]. 上海交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版), 2006; 26(6)∶643.
  1. 1. 蔣小云, 陳述枚. 門靜脈海綿樣變性的診療進(jìn)展 [J]. 國外醫(yī)學(xué)·兒科學(xué)分冊(cè), 1999; 26(3)∶128.
  2. 2. 馮子毅, 劉 磊, 夏 培， 等. 小兒門靜脈海綿樣變性的分型及手術(shù)方式選擇的探討 [J]. 中國現(xiàn)代醫(yī)學(xué)雜志, 2004; 14（8）∶114.
  3. 3. Karagulle E, Turk E, Gokturk HS, et al. Prothrombin 20210 G/A defect as a cause of mesenteric venous infarction: report of a case [J]. Surg Today, 2007; 37(3)∶251.
  4. 4. Hwang S, Moon KM, Park JI, et al. Retroduodenal resection of ampullary carcinoid tumor in a patient with cavernous transformation of the portal vein [J]. J Gastrointest Surg, 2007; 11(10)∶1322.
  5. 5. Ohnishi K, Okuda K, Ohtsuki T, et al. Formation of hilar collaterals or cavernous transformation after portal vein obstruction by hepatocellular carcinoma. Observations in ten patients [J]. Gastroenterology, 1984; 87(5)∶1150.
  6. 6. Gonen C, Akarsu M, Solmaz D, et al. Hodgkin’s disease presenting with chylous ascites and cavernous transformation of the portal vein [J]. Dig Dis Sci, 2007; 52(12)∶3511.
  7. 7. Lupescu I, Masala N, Capsa R, et al. CT and MRI of acquired portal venous system anomalies [J]. J Gastrointestin Liver Dis, 2006; 15(4)∶393.
  8. 8. 方馳華, 項(xiàng) 楠, 范應(yīng)方, 等. 64層螺旋CT三維成像在消化系統(tǒng)疾病診治中的臨床應(yīng)用價(jià)值 [J]. 中華外科雜志, 2007; 45(13)∶909.
  9. 9. 齊立行, 杜國元, 陳佛來. 門靜脈海綿樣變(附2例報(bào)告) [J]. 中國實(shí)用外科雜志， 1998; 18（8）∶480.
  10. 10. Frutos Bernal MD, Fernández Hernández JA, Carrasco Prats M, et al. Portal-splenic-mesenteric venous thrombosis secondary to a mutation of the prothrombin gene [J]. Gastroenterol Hepatol, 2005; 28(6)∶329.
  11. 11. Miniati DN, Padidar AM, Kee ST, et al. Portal vein thrombosis after laparoscopic splenectomy: an ongoing clinical challenge [J]. JSLS, 2005; 9(3)∶335.
  12. 12. 楊 鎮(zhèn), 劉飛龍, 戴植本, 等. 賁門周圍血管離斷術(shù)治療門靜脈高壓癥的療效分析 [J]. 中華普通外科雜志, 1998; 13(2)∶74.
  13. 13. 楊 靈, 肖渝清, 陳矢明, 等. 門靜脈海綿樣變的手術(shù)治療 [J]. 腹部外科, 2003； 16(2)∶118.
  14. 14. Matsumoto H, Suzuki F, Souda K, et al. Improved long-term survival following complete eradication of esophageal varices by sclerotherapy [J]. Hepatogastroenterology, 1999; 46(25)∶172.
  15. 15. 曹 農(nóng), 俞永江, 柴 琛, 等. 門靜脈高壓癥外科治療185例 [J]. 肝膽胰外科雜志, 2008; 20(4)∶286.
  16. 16. Condino AA, Ivy DD, O’Connor JA, et al. Portopulmonary hypertension in pediatric patients [J]. J Pediatr, 2005; 147(1)∶20.
  17. 17. Warren WD, Henderson JM, Millikan WJ, et al. Management of variceal bleeding in patients with noncirrhotic portal vein thrombosis [J]. Ann Surg, 1988; 207(5)∶623.
  18. 18. Bambini DA, Superina R, Almond PS, et al. Experience with the Rex shunt (mesenterico-left portal bypass) in children with extrahepatic portal hypertension [J]. J Pediatr Surg, 2000; 35(1)∶13.
  19. 19. Wax JR, Pinette MG, Cartin A, et al. Cavernous transformation of the portal vein complicating pregnancy [J]. Obstet Gynecol, 2006; 108(3 Pt 2)∶782.
  20. 20. 趙龍栓, 范應(yīng)中, 許培欽. 改良脾肺固定術(shù)治療門靜脈海綿樣變性 [J]. 中國綜合臨床, 2003; 19(10)∶950.
  21. 21. 肖渝清, 胡先典. 門靜脈海綿樣變的手術(shù)治療 [J]. 中華肝膽外科雜志, 2003; 9（10）∶625.
  22. 22. Walser EM, Soloway R, Raza SA, et al. Transjugular portosystemic shunt in chronic portal vein occlusion: importance of segmental portal hypertension in cavernous transformation of the portal vein [J]. J Vasc Interv Radiol, 2006; 17(2 Pt 1)∶373.
  23. 23. Senzolo M, Tibbals J, Cholongitas E, et al. Transjugular intrahepatic portosystemic shunt for portal vein thrombosis with and without cavernous transformation [J]. Aliment Pharmacol Ther, 2006; 23(6)∶767.
  24. 24. 李德宇. 門靜脈海綿樣變性的外科診斷與治療 [J]. 實(shí)用兒科臨床雜志, 2005; 20(8)∶812.
  25. 25. 熊毅敏, 徐維田, 王一鳴， 等. 門靜脈海綿樣變性11例臨床分析 [J]. 實(shí)用醫(yī)學(xué)雜志, 2005; 21(5)∶484.
  26. 26. 宋軍民, 田 豐, 李 巖， 等. 門靜脈海綿樣變性10例臨床分析 [J]. 遼寧醫(yī)學(xué)雜志, 2004; 18(2)∶93.
  27. 27. 曠歷瓊. 門靜脈海綿樣變性7例臨床分析 [J]. 現(xiàn)代中西醫(yī)結(jié)合雜志, 2007; 16（34）∶5109.
  28. 28. 花 榮, 孫勇偉, 吳志勇. 聯(lián)合手術(shù)治療兒童門靜脈海綿樣變性肝前性門靜脈高壓癥 [J]. 肝膽外科雜志, 2005; 13（6）∶428.
  29. 29. 張明滿, 金先慶, 嚴(yán)律南, 等. 親體肝移植治療兒童門靜脈海綿樣變性3例臨床分析　[J]. 中華肝臟病雜志, 2008; 16(4)∶270.
  30. 30. Hajdu CH, Murakami T, Diflo T, et al. Intrahepatic portal cavernoma as an indication for liver transplantation [J]. Liver Transpl, 2007; 13(9)∶1312.
  31. 31. Silva MA, Jambulingam PS, Gunson BK, et al. Hepatic artery thrombosis following orthotopic liver transplantation: a 10-year experience from a single centre in the United Kingdom [J]. Liver Transpl, 2006; 12(1)∶146.
  32. 32. Bauer J, Johnson S, Durham J, et al. The role of TIPS for portal vein patency in liver transplant patients with portal vein thrombosis [J]. Liver Transpl, 2006; 12(10)∶1544.
  33. 33. 王 俊, 蔡 威, 潘偉華， 等. 肝移植治療小兒先天性門靜脈海綿樣變 [J]. 上海交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版), 2006; 26(6)∶643.