断流术加食管下段横断术治疗门静脉高压症上消化道出血  

Use of staple in the pericardial devascularization for treatment of upper GI bleeding due to portal hypertension

作　　者：陈紫千[1] 

机构地区：[1]上海交通大学附属第一人民医院松江分院普外科,201600

出　　处：《临床外科杂志》2010年第10期680-681,共2页Journal of Clinical Surgery

摘　　要：目的探讨门静脉高压贲门周围血管离断术加食管下段横断术治疗上消化道出血的效果。方法78例门静脉高压症患者，28例行断流术加胃肠吻合器食管下段横断术，50例行单纯门奇断流术。结果术后再出血率分别为4．17％（1／24）和52．8％（23／44）。两组再出血发生率比较，差异有统计学意义（P〈0．001）。两组食管下段及胃底静脉曲张消失率为79．17％（19／24）和11％（5／44），两组比较，差异有统计学意义（P〈0．001）。结论门奇断流术联合胃肠吻合器食管下段切割术治疗门静脉高压症能有效地预防、减少术后食管、胃底曲张静脉再出血，止血效果较单纯门奇断流术要好。Objective To explore the therapeutic effect of use of staple in pericardial devascularization on upper GI bleeding caused by portal hypertension. Methods Clinical data of 78 patients with portal hypertension ,who underwent pericardial devascularization in combination with use of staple（ n = 28, staple group） or not（ n = 50, control group） from Aug 1999 to Aug 2006 in our hospital, were retro- spectively analyzed. The re - bleeding and disappearing rate of varicose veins in the lower part of esopha- gus and gastric fundus and the complications were evaluated. Results There was no death due to the op- eration. One patient（1/24） in the staple group had upper GI re - bleeding during follow up and 23 （23/ 44） patients developed upper GI re - bleeding in the control group. The re - bleeding rate was 4.17% and 52.8% in the two groups with difference being significant（ P 〈0.05）. The disappearing rate of varicose veins was 97.17% in the staple group and 11% in the control group （ P 〈 0.05 ）. Conclusion The therapeutic effect of pericardial devascularization could be improved by use of staple.

关 键 词：门静脉高压症 吻合术 外科 食管胃底静脉曲张 

分 类 号：R657.34[医药卫生—外科学]