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患者女性,62岁。因脾肺大10年于1986年7月入院,既往曾两次呕血而住院治疗。检查:消瘦,腹壁静脉曲张,腹水征(+),肝未触及,脾肋缘下10cm。血小板4.1万,HBsAg(-),血浆总蛋白6.8g,白蛋白3.5g,凝血酶原时间13秒,血胆红素和转氨酶属正常。食道吞钡造影示食管中下段静脉曲张。诊断为肝硬化、门脉高压、脾亢。于8月6日在硬膜外麻醉下行门静脉造影测压、脾切除、吻合器食道横断、门奇静脉断流术。术中见胃小弯网膜及食道胃底静脉均明显曲张,断流后门静脉压力下降40mmH_2O。断流前门静脉造影示胃冠状静脉扩张扭曲,两支进入食道的
Patient female, 62 years old. Due to splenomegaly for 10 years in July 1986 admitted to the hospital, had two vomiting and hospitalization. Check: weight loss, abdominal varicosity, signs of ascites (+), liver not touched, spleen ribs 10cm. 41,000 platelets, HBsAg (-), total plasma protein 6.8g, albumin 3.5g, prothrombin time 13 seconds, serum bilirubin and aminotransferase normal. Esophageal barium angiography showed lower esophageal varices. Diagnosis of cirrhosis, portal hypertension, hypersplenism. On August 6, epidural anesthesia underwent portal venography angiography, splenectomy, stapler esophageal transection, portal azygos disconnection. Surgery, see the lesser curvature of the omentum and esophageal gastric varices were significantly varicocele, portal venous pressure decreased 40mmH_2O. The anterior portal venography was performed to show that the coronary venous dilatation was distorted and the two entered the esophagus