选择性断流加大网膜包肾术预防术后门静脉系统血栓形成的研究  

Prevention of postoperative portal vein thrombosis in patients undergoing selective periesophagogastric devascularization combined with omentorenopexy

作　　者：王超[1] 杨镇[1] 肖亮[2] 李岽健[1] 乌剑利[1] 魏卫卫[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院综合科,湖北武汉430030 [2]江苏省镇江市第一人民医院普外科,江苏镇江212002

出　　处：《外科理论与实践》2009年第5期543-545,共3页Journal of Surgery Concepts & Practice

摘　　要：目的:评价选择性贲门周围血管离断(sPCDV)加大网膜包肾术(ORP)治疗门静脉高压症对术后门静脉系统血栓形成(PVT)的预防作用。方法:将我院2003年11月至2007年11月外科收治的196例门静脉高压症病人分成3组,即sPCDV+ORP组(A组,n=113)、单纯sPCDV组(B组,n=31)和非sPCDV组(C组,n=52)。比较3组病人术后PVT的发生率、术后再出血情况及生存情况。结果:A组术后PVT的发病率为6.19%(7/113),明显低于B组(12.90%,4/31)和C组(19.23%,10/52)(P<0.05),且B组与C组比较亦有显著差异(P<0.05)。A组术后再出血率为1.77%(2/113),与B组(6.45%,2/31)和C组(11.54%,6/52)比较有显著差异(P<0.05),且B组与C组比较亦有显著差异(P<0.05)。A、B和C组术后3年生存率分别为93.81%(106/113)、96.77%(30/31)及92.45%(49/52)(P>0.05)。结论:sPCDV+ORP可显著降低术后PVT率,有效减少术后再出血的发生,且简便易行,值得推广。Objective To evaluate the preventive effects of selective periesophagogastric devascularization（sPCDV） combined with omentorenopexy（ORP）in the treatment of postoperative portal vein thrombosis （PVT） in patients with portal hypertension. Methods A total of 196 patients with portal hypertension admitted from Nov.2003 to Nov.2007 were divided into 3 groups： Group A（n=113）, patients undergoing sPCDV combined with ORP; Group B（n=31）, sPCDV only was performed; and Group C（n=52）,the non-sPCDV group. The rate of postoperative portal vein thrombosis（PVT）, recurrence of bleeding and survival rate were compared between the three groups. Results The rate of postoperative PVT was 6.19% （7/113） in Group A, which was significantly lower than those in group B （12.90%,4/31） and group C（19.23%,10/52） （P〈 0.05）; meanwhile, the PVT rate of group B was obviously lower than that of group C. There was a higher recurrence rate of bleeding in Group C, 11.54%（6/52） than in Groups A 1.77%（2/113） and B 6.45%（2/31） （P〈0.05）. The 3-year survival rate in the groups A, B and C were 93.81%（106/113）, 96.77%（30/31） and 92.45%（49/52） respectively （P〉0.05）. Conclusions sPCDV combined with ORP can effectively decrease the postoperative PVT and re-bleeding rates in patients with portal hypertension; it deserves to be recommended due to its effect and convenience in application.

关 键 词：选择性贲门周围血管离断术 大网膜包肾术 血栓形成 

分 类 号：R657.34[医药卫生—外科学]