重视我国门静脉高压症外科治疗的问题

Attention to the surgical treatment of portal hypertension in China

  • 摘要: 肝硬化门静脉高压症全世界十分常见,严重威胁人民的生命健康。由于受到药物、内镜套扎、放射介入以及肝移植等治疗方法的严重冲击,打破了过去门静脉高压症外科治疗一统天下独领风骚的局面。门静脉高压症外科治疗何去何从?究竟是不是“一门业已消失的外科技术”?事实上门静脉高压症的外科治疗不会消失,仍然在发挥独特的、不可或缺的重要作用,其他治疗方法均无法取代。这是毋庸置疑的临床事实。目前腹腔镜下贲门周围血管离断术已广泛推广应用,其治疗优势突出,具有损伤小,出血量少,术后并发症发生率低,恢复快等显著优点。而多学科团队协作的诊断与治疗模式可以充分发挥综合各学科优势,为患者提供精准、规范的个体化诊断与治疗方案。重视目前门静脉高压症外科治疗所面临的问题,积极组织开展临床多中心的前瞻性随机对照试验,旨在提供更高级别的临床证据,研究新的手术方式,撰写新的符合我国国情的门静脉高压症外科治疗指南与共识,指导临床实践,将进一步提高我国门静脉高压症的诊断与治疗水平以及国际话语权。

     

    Abstract: Portal hypertension caused by liver cirrhosis is common and severely threatens the patients′ health. The dominant position of the conventional surgical treatment was strongly challenged by the pharmacological, endoscopic esophageal variceal ligation (EVL), transjugular intrahepatic portosystemic shunt (TIPS) and liver transplantation. So, what the prospect of surgical treatment is and whether it has disappeared? In fact, the surgical treatment is not only far from disappearing, but also play a unique and indispensable role, and could not be displaced by other treatments. Nowadays, the laparoscopic pericardial devascularization is widespread used, shows the increasingly prominent and distinct advantages of less injury and bleeding, fewer complications and faster recovery. The generalizing of multidisciplinary treatment (MDT) will combine advantages of varies subjects then provide the individual and precise diagnosis and treatment plan to patients. Authors should pay attention to the problems and then organize the clinical multicenter RCT studies, provide high level evidences, explore new surgical procedures, compose new clinical guidelines and consensuses which consistent with our national situations, thus to guide the clinical practice and will further improve the treatment of portal hypertension and raise our country′ voice in this subject.

     

/

返回文章
返回