To investigate the change of the portal venous pressure (PVP), conjugated glycocholic acid (CGA) and pancreatic glucagon (PG) concentration in rats peripheral and portal venous blood in the course of experimental liver cirrhosis induced with carbon tetrachloride and to investigate the mentioned changes after portalazygous devascularization. The authors found that in the early stage of cirrhosis the PVP and the concentration of CGA and PG in peripheral venous blood were increased markedly, CGA in portal vein was decreased and PG in portal vein was increased in early stage of liver cirrhosis.With the extent of liver cirrhosis the indexes above changed more markedly. After portalazygous devascularization the concentration of CGA in peripheral vein in the cirrhotic rats was increased but PVP, the concentration of CGA in portal vein and PG in peripheral and portal vein did not change.There was no change in nornal rats. The results suggest that the variation in CGA in peripheral vein can accurately reflect the degree of damage to liver cells, thus making the diagnosis of liver cirrhosis earlier and judging the degree and prognosis of liver cirrhosis.The concentration of PG in portal venous and peripheral vein relate to PVP in liver cirrhosis.Portalazygous devascularization can maintain PVP and PG in portal vein and do not affect liver function of the control rats but it can damage liver cell in cirrhotic rats.
In the treatment of portal hypertension, association of both hassab operation and splenorenal shunt was performed selectively on six cases by authors from 1987 to 1994, and better results were obtatined in five patients. In this article, the experience and operative Techniques are introduced in detail, and he advantages of this procedure are evaluated.
Electron spin resonance (ESR) spectroscopy and spin trapping agent PBN were applied to measure directly the changes of oxygen free redicals (OFR) in gastric mucosa of rats with portal hypertension (PHT) injured by shockreperfusion, and treated with superoxide dismutase (SOD), radix salviae miltiorrhizae (RSM), with concomitant monitoring activity of SOD and pathology of gastric mucosa. Results showed that the amount of OFR increased markedly in gastric mucosa of PHT rats during the shock-reperfusion. The pathological changes were in accordance with alteration of the amount of OFR and the activity of SOD. Gastric mucosa in PHT was more susceptible to shock-reperfusion insult than normal controls. The anti-oxidant SOD, RSM used at early stage exerted mild gastric mucosal insult through different mechanisms.
Objective To evaluate the efficacy of the subtotal splenectomy versus total splenectomy with gastroesophageal devascularization for patients of hepatic cirrhosis and portal hypertension. Methods We searched the Cochrane Library (Issue 2, 2008), MEDLINE (1966 to August, 2008), EMbase (1966 to August, 2008), the China Biological Medicine Database (1978 to August, 2008), Chinese Sci-tech Periodical Full-text Database (1989 to August, 2008) and Chinese Periodical Full-text Database (1994 to August, 2008), as well as hand-searched several related journals and conference proceedings for the randomized controlled trials involving the comparison of the efficacy of the subtotal splenectomy with the total splenectomy for the patients of the hepatic cirrhosis and portal hypertension. Results Three studies involving 136 patients were identified. The results of two studies indicated that both of the subtotal splenectomy increased less the peripheral platelet count and there was a statistically significant difference between the two groups [WMD= – 39.27, 95%CI (– 62.57, – 15.97)]. Two studies indicated that the serum tuftsin level was increased significantly after the subtotal splenectomy [WMD= 165.28, 95%CI (159.36, 171.21)]. One study indicated that both of the subtotal splenectomy and total splenectomy with gastroesophageal devascularization increased the peripheral white blood cell count and there was statistical difference between the two groups [WMD= – 0.93, 95%CI (– 1.52, – 0.34)]. There was no statistical difference in serum IgA level between the two groups. One study indicated the average fever time after the total splenectomy was longer than the subtotal splenectomy; there was statistical differences in 5 years survival rate between the two groups (Plt;0.05). Conclusions After the subtotal splenectomy the hypersplenism of patients suffered from hepatic cirrhosis and portal hypertension was corrected obviously and the blood cells were increased smoothly so that high blood viscosity was prevented and occurrence of the thrombotic diseases was decreased. And the immune system reserve functions of the patients with hepatic cirrhosis and portal hypertension were maintained. More randomized controlled trials, with large sample sizes, may lead to more accurate results.
目的探讨近端脾肾分流联合贲门周围血管离断术治疗肝硬变门脉高压症的疗效。方法回顾分析我院1994~2004年10年期间应用近端脾肾分流联合贲门周围血管离断术治疗62例肝硬变门脉高压病例。结果本组无手术死亡，随访56例，随访时间4~56个月，随访结果： 26例肝功能较前有所改善，49例静脉曲张明显减轻，无静脉破裂出血； 发生吻合口血栓5例，肝性脑病3例，因肝衰死亡3例。结论近端脾肾分流联合贲门周围血管离断术治疗肝硬变门脉高压症效果好，疗效满意。
门脉高压性胃病是肝硬变门脉高压症患者的主要并发症之一，病变几乎累及全部消化道，现就门脉高压性胃病的临床表现、病理特点、发病机理、诊断与治疗讨论如下……
目的 探讨胰源性门脉高压症的临床特点和诊治方法。 方法 回顾性分析聊城市第二人民医院1995年5月至2005年10月收治的23例胰源性门脉高压症病例资料。结果 全部病例均在术前确诊，并接受手术治疗。行胰头十二指肠切除术6例、胰腺囊肿内引流术1例、胰体尾切除术4例、脾切除术6例、介入行选择性脾动脉插管栓塞术3例及曲张静脉内镜下套扎硬化术3例。术后死亡2例,发生胰瘘1例。生存者临床症状均明显改善。结论 胰源性门脉高压症诊断不难，治疗应兼顾原发病及门脉高压两方面，才能取得较好疗效。
【摘要】目的 探讨肝硬变门静脉高压症患者术前肝脏备功能的评估方法。方法 用Logistic多元回归法分析了78例门静脉高压症行断流术患者术后出现肝功能不全的相关因素，从中筛选与肝功不全关系最密切的危险因子。结果 术后发生肝功不全影响最大的因素依次为： 肝性脑病（EN）、血浆吲哚氰绿潴留试验（ICGR15 min）及门静脉充血指数（PCI）等，而术前的血清总胆红素（TBIL）、白蛋白（A）、凝血酶原时间（PT）、门静脉内径（dp）、门静脉流速（Vp）及门静脉流量（Qp）等因素，在多元回归中所占比例不大。结论 综合分析术前患者临床指标和肝功能实验室检查有助于评价肝硬变患者肝储备功能，预测手术风险及术后转归。