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目的探讨晚期血吸虫病门静脉高压症合并门静脉海绵样变的外科治疗方式。方法对湖南省血吸虫病防治所附属湘岳医院18例晚期血吸虫病合并门静脉海绵样变患者的临床资料进行回顾性分析。结果16例患者行脾切除贲门周围血管离断术;2例患者先行内镜食管曲张静脉套扎术,后因再次食管静脉曲张破裂出血,分别于术后32、40个月行脾切除贲门周围血管离断术。术后随访6~72个月,未再发现食管胃底静脉曲张。结论脾切除贲门周围血管离断术适用于晚期血吸虫病门静脉高压合并门静脉海绵样变的治疗。
Objective To investigate the surgical treatment of portal schwannoma complicated by portal vein sponge-like change in patients with advanced schistosomiasis. Methods The clinical data of 18 patients with advanced schistosomiasis with portal cavernous transformation in Hunan Provincial Affiliated Hospital of Hunan Province for schistosomiasis control were retrospectively analyzed. Results Sixteen patients underwent splenectomy and pericardial revascularization. Two patients underwent endoscopic esophageal varicose vein ligation followed by re-esophageal variceal hemorrhage. Splenectomy was performed at 32 and 40 months after operation, respectively. Vascular ablation. Postoperative follow-up 6 to 72 months, no esophageal and gastric varices were found. Conclusions Splenectomy and pericardial devascularization are suitable for the treatment of advanced schistosomiasis with portal hypertension and portal vein cavernous transformation.