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门脉高压症是一常见的临床综合征,食道静脉曲张破裂出血是其最严重的并发症。由于门脉高压症常由肝硬化所致,而肝硬化在我国又甚多见,因此有效地对本症作出处理是内、外科临床医师共同的任务。近年来,门脉高压的诊治水平有了显著的提高,表现在对一些非肝硬化所致的门脉高压以及门脉高压时的“异位”表现有了进一步认识;B 超、多普勒、经皮肝穿刺门脉插管等新技术的应用,使得临床上可能简便而正确地研究门脉系统和肝内血循环状态;血管加压素、气囊压迫法虽是治疗食道静脉曲张出血的老方法,但对其如何正确使用却有了新的看法。β受体阻滞剂和血管扩张剂的降门脉压力的作用,更为治疗本症开辟了新途径。内镜检查有助于预测、诊断食道静脉曲张出血,经内镜作硬化疗法已成为止血和预防再出血的重要措施之一。至于门脉高压症的外科治疗,门体静脉分流术与门奇静脉断流术各有利弊,对其评价有待积累更多资料。本刊特邀有关专家对门脉高压症的问题分别作了简要的阐述,以冀对广大临床工作者有所裨益。
Portal hypertension is a common clinical syndrome, esophageal variceal bleeding is its most serious complication. As portal hypertension is often caused by cirrhosis, and cirrhosis is very common in our country, so the effective treatment of this disease is a common task for clinicians and surgeons. In recent years, the diagnosis and treatment of portal hypertension has been significantly improved, manifested in some non-cirrhosis caused by portal hypertension and portal hypertension when the “ectopic” performance has been further understanding; B-, Doppler , Percutaneous transhepatic portal vein catheterization and other new technologies make it possible to clinically simple and accurate study of the portal system and intrahepatic blood circulation; vasopressin, balloon compression method is the treatment of esophageal variceal bleeding Method, but has a new perspective on how to use it correctly. β-blockers and vasodilators reduce the role of portal pressure, more for the treatment of this disease has opened up a new way. Endoscopy can be helpful in predicting and diagnosing esophageal variceal bleeding. Endoscopic sclerostomy has become an important measure to stop bleeding and prevent rebleeding. As for the surgical treatment of portal hypertension, portal vein shunt and portal azygous disconnection have their own advantages and disadvantages, the evaluation needs to be accumulated more information. Articles of special invited experts on portal hypertension were made a brief description of the problem, in order to benefit the majority of clinical workers.