联合术与断流术治疗食道静脉破裂出血疗效比较  

Effect of Combined Operation and Portaazygous Devascularzation in the Treatment of Esophageal Variceal Bleeding

作　　者：熊炳贤[1] 谢敏[1] 孙晋友[1] 李红浪[1] 沈威[1] 

机构地区：[1]江西医学院第二附属医院普外科,江西南昌330006

出　　处：《江西医学院学报》2001年第5期63-65,共3页Acta Academiae Medicinae Jiangxi

摘　　要：目的 :比较分流联合术与断流术治疗食道静脉破裂出血 (EVB)的效果。方法 :2 8例EVB患者随机均分为两组 ,分别施行联合术和断流术。对其术中自由门静脉压 (FPP)、手术前后门静脉血流量 (PVF)、食道吞钡摄片及临床疗效进行比较。结果 :断流术与联合术后FPP平均降低分别为 ( 0 .4土 0 .71)kPa和 ( 0 .98± 0 .2 8)kPa ;断流术后PVF平均增加 ( 92± 64)ml/min ,联合术后平均降低 ( 13 0± 80 )ml/min ;两组间和联合术前后比较差异均有显著性(P <0 .0 5 ) ;联合术组食道静脉曲张和临床疗效均好于断流术组。结论 :联合术是断流术和分流术优缺点互补术 ,具有止血效果确切、作用持久、再出血率低等优点 ,是一种治疗EVB的合理术式。Objective: To compare the effect of combined operation with that of portoay gous devasculerization in treatment of esophageal variceal bleeding (EVB). Methods:28 cases of EVB were randomly devided into two groups: combined operation and portaazygous devascularzation. The FPP, PVF of pre-postoperatovely, Baroum meal, and clinical manifestations were examined. Results: The average values of FPP in portaazygous devascutarzation and combined operation decreased by (0.47±71)kPa and (0.98±26)kPa, respectoely. The average values of PVF increased by (92±4)ml/min after portaazygous devasacularzation and decreased by (130±82)ml/min after combined operation with a significant difference ( P <0.05). The esophageal variceal and clinical manifestations in combined operation were better as compared with those in portaazygous devascularzation. Comclusion: The combined operation is a perfect combination of both shunt and devascularization and it has merits on stopping hemorrhage and on lowing recurrent bleeding rate.

关 键 词：食管和胃静脉曲张 破裂 门奇断流术 脾肾分流术 

分 类 号：R657.3+4[医药卫生—外科学]