Ferraz Alvaro Antônio Bandeira, de Albuquerque Pedro Cavalcanti, Lopes Edmundo Pessoa de Almeida, de Araújo José Guido Corrêa, Carvalho Anderson Henrique Ferreira, Ferraz Edmundo Machado
Department of Surgery, Department of Internal Medicine - Gastroenterology, University Hospital, Federal University of Pernambuco, Recife, PE, Brazil.
Arq Gastroenterol. 2003 Jan-Mar;40(1):4-10. doi: 10.1590/s0004-28032003000100002. Epub 2003 Oct 6.
To evaluate the degree of influence that periportal fibrosis has on clinical development and the long term results of surgical treatment on patients with hepatic-splenic schistosomiasis with previous gastrointestinal hemorrhages.
During the period of 1992-1998, 111 patients underwent surgical treatment for the treatment of hepatic-splenic schistosomiasis with previous gastrointestinal hemorrhages. The degree of fibrosis was classified as: degree I - the portal spaces show a rich increase of young connective cells, a slight collagen production and a varying presence of inflammatory infiltrate. The periportal blade unchangeable (29/111); degree II - there is an expansion of the connective tissue with the emission of radial collagen septa, producing a star shaped aspect (38/111); degree III - the connective septa form bridges with other portal spaces or with the vein, with evident angiomatoid neo-formation (44/111).
The patients with periportal fibrosis degree I present recurrent hemorrhages statistically less than patients with periportal fibrosis degrees II and III, and that the intensity of the periportal fibrosis is not the only pathophysiological factor of the esophageal varices, gastric varices, prevalence of post-operative portal vein thrombosis and hematological and biochemical alterations of the patients with pure mansoni schistosomiasis.
评估门静脉周围纤维化对曾有胃肠道出血的肝脾型血吸虫病患者临床进展及手术治疗长期结果的影响程度。
在1992年至1998年期间，111例曾有胃肠道出血的肝脾型血吸虫病患者接受了手术治疗。纤维化程度分类如下：I度——门管区可见大量年轻结缔组织细胞增生、少量胶原生成及不同程度的炎性浸润。门静脉周围结构无变化（29/111）；II度——结缔组织扩张，有放射状胶原间隔发出，呈星状外观（38/111）；III度——结缔组织间隔与其他门管区或静脉形成桥接，有明显的血管瘤样新生（44/111）。
门静脉周围纤维化I度的患者复发出血的统计学概率低于门静脉周围纤维化II度和III度的患者，且门静脉周围纤维化程度并非单纯曼氏血吸虫病患者食管静脉曲张、胃静脉曲张、术后门静脉血栓形成患病率以及血液学和生化改变的唯一病理生理因素。
