Lodge J P, Mavor A I, Giles G R
J R Coll Surg Edinb. 1989 Apr;34(2):59-62.
Retrospective analysis of 81 patients (average age 48 years) undergoing lienorenal shunt (28) or distal splenorenal (Warren) shunt (53) surgery over a 15-year period (1971-1986) revealed important predictive factors for survival, but showed no significant differences between the two shunt groups in terms of accepted follow-up data over a period of up to 15 years. In 52 patients (64%) active haemorrhage was occurring at the time of operation, or was temporarily controlled by tamponade, and 17 of the 18 deaths (22% operative mortality) occurred in this group. Patients in whom prolonged conservative resuscitation had been attempted fared worse (64% survival), as did patients with poor hepatic reserve (Pugh grade C: 32% survival). Twenty-two patients (27%) rebled within 30 days, 18 following urgent shunts, and 12 died. Seven (11%) of the long-term survivors have suffered recurrent variceal haemorrhage with a clear relationship to shunt or portal system thrombosis. Portasystemic encephalopathy occurred in 13 survivors (20%) with six requiring hospital treatment.
对1971年至1986年这15年间接受脾肾分流术（28例）或远端脾肾（沃伦）分流术（53例）的81例患者（平均年龄48岁）进行回顾性分析，发现了重要的生存预测因素，但在长达15年的可接受随访数据方面，两组分流术之间没有显著差异。52例患者（64%）在手术时发生活动性出血，或通过填塞暂时得到控制，18例死亡患者中有17例（手术死亡率22%）发生在该组。尝试进行长时间保守复苏的患者预后较差（生存率64%），肝储备功能差的患者（普格C级：生存率32%）也是如此。22例患者（27%）在30天内再次出血，18例在紧急分流术后出血，12例死亡。7例（11%）长期存活者发生复发性静脉曲张出血，与分流或门静脉系统血栓形成有明确关系。13例幸存者（20%）发生门体性脑病，其中6例需要住院治疗。
