Petroianu Andy
Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
Rev Soc Bras Med Trop. 2003 Mar-Apr;36(2):253-65. doi: 10.1590/s0037-86822003000200010. Epub 2003 Jun 10.
Portal hypertension is defined by an hepatic venous pressure gradient greater than 5mmHg. It is usually caused by an increase in resistance in the portal-hepatic vascular bed due to obstruction to flow. The severe forms of schistosomiasis usually evolve with portal hypertension, esophageal, intraabdominal, retroperitoneal and abdominal wall varices. Massive bleeding due to esophageal or gastric variceal rupture is the major complication of portal hypertension in schistosomiasis. In regard to treatment, clinical (propranolol, somatostain, octreotide), endoscopic (sclerotherapy, clips and ligature of varices), vascular (TIPS - transjugular intrahepatic portosystemic shunt) and surgical (portosystemic shunts and portovariceal disconnection) approaches have been tried to decrease portal hypertension and prevent bleeding. In the present review the author discusses the subject emphasizing the surgical procedures.
门静脉高压症定义为肝静脉压力梯度大于5mmHg。它通常是由于门静脉-肝血管床血流受阻导致阻力增加所致。严重的血吸虫病通常会发展为门静脉高压症、食管、腹腔内、腹膜后和腹壁静脉曲张。食管或胃静脉曲张破裂导致的大量出血是血吸虫病门静脉高压症的主要并发症。在治疗方面，已经尝试了临床（普萘洛尔、生长抑素、奥曲肽）、内镜（硬化疗法、套扎和静脉曲张结扎）、血管（经颈静脉肝内门体分流术-TIPS）和手术（门体分流术和门静脉断流术）等方法来降低门静脉高压并预防出血。在本综述中，作者着重讨论了外科手术相关主题。
