目的探讨小儿门静脉海绵样变的临床特点、诊断、手术治疗经验及对比断流术与分流术疗效。方法对2003年1月~2013年12月在我院诊治的17例小儿门静脉海绵样变患儿行回顾性分析。将患儿年龄、诊断方法、手术治疗和预后进行分析。统计学采用字2检验，以<0.05为显著性检验水准。结果手术治疗可明显降低门静脉高压。17例行手术治疗患儿，6例行贲门周围血管离断流术中4例术后再次出血，1例患儿出血后死亡。7例行脾肾静脉分流术中1例术后出血。2例行断流分流联合手术中1例术后出血。2例行脾腔静脉分流术术未发生出血。分流术与断流术出血率分别为11.1%、66.7%,两组患儿出血率差异有显著性（=0.029）。结论断流手术术后再出血远高于分流手术；大年龄患儿手术效果较小年龄患儿好；手术治疗CTPV应使门静脉压力降低，脾静脉>1.0cm患儿可行分流手术。脾静脉<1.0cm患儿最好不要行单纯断流术,应加行分流手术。%Objective To investigate the cavernous transformation of portal vein in children of the clinical features, diagnosis, operation treatment and contrast devascularization and shunt ef ect. Methods 2003 January to 2013 December in our hospital 17 cases of cavernous transformation of portal vein in children underwent retrospective analysis. The age of the patients, diagnosis treatment and prognosis methods, operation analysis. Statistical y by chi square test, <0.05 test of significance level. Results The operation treatment can significantly reduce the portal hypertension. 17 cases were treated by operation in 6 cases, bleeding again pericardia vascular disconnection in the 4 cases, 1 cases of bleeding after death. Hemorrhage in 7 cases of splenorenal shunt in 1 cases. 2 joint operation in 1 cases of bleeding after devascularization shunt routine. 2 cases of splenocaval shunt without bleeding. Rates were 11.1%, 66.7%shunt and devascularization hemorrhage, bleeding rate dif erence between the two groups was significant ( =0.029). Conclusion Devascularization operation postoperative rebleeding than shunt operation; high age children with good operation effect is smal age; operation treatment of CTPV should make the portal venous pressure decreased in children with >1.0cm is feasible, splenic vein shunt operation. Splenic vein in children with<1.0cm had bet er not simple devascularization, should additional shunt operation.
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