Lam K C, Juttner H U, Reynolds T B
Dig Dis Sci. 1981 Apr;26(4):346-52. doi: 10.1007/BF01308377.
This study examined the effect of large spontaneous portosystemic shunts on the incidence of variceal hemorrhage and hepatic encephalopathy. Twenty cases of chronic liver disease with large spontaneous shunts were compared with a group of patients with liver disease and with Cruveilhier-Baumgarten (C-B) murmurs and with a control group having liver disease and absence of large shunts on angiography. Gastrointestinal hemorrhage was present in similar proportions of patients in the three groups. Hepatic encephalopathy occurred more frequently in the spontaneous shunt group and C-B murmur group. The encephalopathy was spontaneous in 12 of 14 patients with large natural shunts whereas it was precipitated by events such as gastrointestinal bleeding, diuretics, or infection in 14 of 15 of the patients with C-B murmur and five of the seven controls. Therefore, spontaneous portosystemic shunts do not protect against gastrointestinal hemorrhage and are associated with an increased risk of spontaneous hepatic encephalopathy.
本研究探讨了巨大自发性门体分流对静脉曲张出血和肝性脑病发生率的影响。将20例患有巨大自发性分流的慢性肝病患者与一组有肝病且伴有克吕韦耶 - 鲍姆加滕（C - B）杂音的患者以及一组有肝病且血管造影显示无巨大分流的对照组进行比较。三组患者中出现胃肠道出血的比例相似。肝性脑病在自发性分流组和C - B杂音组中更频繁发生。14例有巨大自然分流的患者中有12例脑病为自发性，而15例有C - B杂音的患者中有14例以及7例对照组中有5例的脑病是由胃肠道出血、利尿剂或感染等事件诱发的。因此，自发性门体分流不能预防胃肠道出血，且与自发性肝性脑病风险增加相关。
