贲门周围血管离断术治疗门静脉高压症693例临床报告  

Treatment of portal hypertension by peri-cardiac devascularization:report of 693 cases

作　　者：杨维良[1] 张伟峰[1] 张新晨[1] 马玉林[1] 

机构地区：[1]哈尔滨医科大学附属第二医院普外科,150086

出　　处：《临床外科杂志》2006年第10期632-633,共2页Journal of Clinical Surgery

摘　　要：目的总结贲门周围血管离断术治疗门静脉高压症的效果。方法回顾性分析自1978年至2002年行贲门周围血管离断术693例的临床资料。结果急诊手术84例,手术止血率76.2%(64/84),手术总死亡率7.2%(50/693),主要死亡原因为上消化道大出血、腹腔大出血、肝性脑病和肝功能衰竭。平均随访时间3.5年,5年生存率92%、10年生存率60%。术后复发性出血率7%(5年)和12.5%(10年)。肝性脑病发生率3%(5年)和5%(10年)。远期主要死亡原因:上消化道大出血15例,肝功能衰竭23例,并发原发性肝癌7例。结论必须严格掌握手术适应证和手术时机,断流术彻底是提高疗效的关键。Objective To summarize the effect of per/- cardiac devascularization in the treatment of portal hypertension. Methods The clinical data of 693 cases subject to peri - cardiac devascularization from 1978 to 2002 were retrospectively analyzed. Results Hemostasis rate of emergency operation was 76.2 % （64/84） and total operative mortality was 7.2 96 （50/693）. The main dead causes were as follows：upper gastrointestinal tract hemorrhage, celiac hemorrhage, hepatic encephalopathy and liver failure. Average follow - up duration was 3.5 years, 5 - year survive rate was 92 % and 10 - year survive rate was 60 %. Postoperative recurdescent hemorrhage rate was 796 （5 years） and 12.5 % （10 years）,The rate of hepatic encephalopathy was 3% （5 years） and 5% （10 years）. The long - term major dead causes were as follows：upper gastrointestinal tract hemorrhage （15 cases）, liver failure （23 cases） and subsequent primary hepatic cancer （7 cases）. Conclusion Peri-cardiac devascularization has a satisfactory effect in the treatment of portal hypertension. In order to improve the curative effectiveness,the operative indication and opportunity should be held strictly and the disconnection must he thorough.

关 键 词：门静脉高压症 贲门周围血管离断术 

分 类 号：R657.34[医药卫生—外科学]