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目前,对食道静脉曲张的治疗分为门静脉减压术、直接处理曲张静脉的直达手术和不用手术的非损伤性疗法(硬化疗法)。这三种疗法在临床应用方面几乎都得到同样的评价。门静脉减压术包括使门脉几乎所有血流流入腔静脉系的所谓完全性分流和只把食道静脉曲张范围的减压作为目的的选择性分流。完全性分流的代表是门静脉一下腔静脉吻合术,选择性分流的代表是远端脾肾分流术。但是这些手术存在的问题是术后发生肝性脑病。门—腔静脉吻合术后,50%肝硬变、70%寄生虫性病例发生脑病,即使在Warren 本人的报告中以不发生脑病为目的的远端脾肾分流术后也有26%发生脑
Currently, the treatment of esophageal varices is divided into portal vein decompression, direct treatment of varicose vein direct surgery and non-surgical non-invasive treatment (sclerotherapy). Almost all of the three therapies receive the same assessment of clinical application. Portal venous decompression involves the selective shunting of the so-called complete shunt of almost all blood flow into the vena cava of the portal vein and the decompression of only the esophageal varix. The representative of complete shunt is a portal venous anastomosis, the representative of selective shunt is distal splenorenal shunt. However, the problem with these procedures is the occurrence of hepatic encephalopathy after surgery. After portal-venous anastomosis, encephalopathy occurs in 50% of cirrhotic cases and in 70% of parasitic cases, even though 26% of brain spikes occur after distal splenorenal shunting for the purpose of encephalopathy in Warren’s own report