晚期血吸虫病门脉高压症术后近期再手术分析  

Analysis of Reoperation on Advanced Schistosomiasis Patients with Portal Hypertension

作　　者：邓维成[1] 丁国建[1] 王鹏[1] 李紫成[1] 潘舸[1] 陈学金[1] 刘佳新[1] 

机构地区：[1]湖南省血吸虫病防治所附属湘岳医院,岳阳414000

出　　处：《热带医学杂志》2009年第12期1418-1419,1457,共3页Journal of Tropical Medicine

基　　金：湖南省卫生厅(No.A2007009)

摘　　要：目的分析晚期血吸虫病门脉高压症术后近期再手术原因,探讨控制再手术率的措施。方法回顾性分析2004年9月至2009年9月湖南省晚期血吸虫病救助期间23例近期再手术病例资料。结果晚期血吸虫病门脉高压症手术589例,近期再手术23例,再手术率为3.9%。其中2次手术16例,3次手术6例,4次手术1例。再手术原因有腹腔大出血、消化道穿孔、胰尾部损伤、粘连性肠梗阻、切口感染、切口裂开、膈下脓肿。所有患者均痊愈出院,随访5～20月均无严重并发症出现。结论晚期血吸虫病术后近期再次手术原因与术前准备不充分,术中操作过失及术后处理不到位有关。加强围术期处理是提高手术质量和疗效、控制再手术率的关键。Objective To analyze the causes of reoperations due to portal hypertension and to develop strategies to reduce reoperations in advanced schistosomiasis. Method Medical records of 23 patients with advanced schistosomiasis and recent reoperations between Sep.2004 and Sep.2009 were analyzed. Results There were 589 surgical eases of advanced schistosomiasis with portal hypertension, in which 23 cases （3.9%） had a recent history of reoperations.Of these 23 cases, 16 cases had 2 times, 6 cases had 3 times and 1 case had 4 times of operation. Intraabdominal bleeding, gastrointestinal perforation, pancreatic tail injury, adhesive intestinal obstruction, wound infection, wound dehiscence and subphrenic abscess are the reasons for reoperation.All patients were cured and discharged after the treatment. Serious complications were not observed at 5 to 20 months after operation. Conclusion The cause of reoperation is correlated with the inadequate preoperative preparation, faulty manipulation and improper postoperative management.Strengthening of perioperative management can improve the quality of operation and reduce the rate of reoperation.

关 键 词：门脉高压症 晚期血吸虫病 近期再手术 

分 类 号：R532.2[医药卫生—内科学]