分流联合断流术治疗门静脉高压疗效分析  

Proximal spleno-renal shunt plus pericardial devascularization for management of portal hypertension

作　　者：于智勇[1,2] 许程伟[1,2] 张艮龙[1,2] 

机构地区：[1]安徽医科大学宿州临床学院 [2]安徽省宿州市立医院普外科,234000

出　　处：《蚌埠医学院学报》2011年第8期828-830,共3页Journal of Bengbu Medical College

摘　　要：目的:观察分流联合断流术治疗门静脉高压的临床疗效。方法:对112例门静脉高压者分别采用分流断流联合术31例和断流术81例,观察手术前后门静脉压力(FPP)变化以及近远期疗效。结果:分流断流联合术组FPP下降优于断流术组(P<0.01);2组术后病死、近期再出血及肝性脑病发生率差异无统计学意义(P>0.05);分流断流联合术组远期再出血和腹水发生率均低于断流术组(P<0.05),远期肝性脑病的发生率差异无统计学意义(P>0.05)。结论:分流断流联合手术治疗门静脉高压,既明显降低出血率又不增加脑病发生,应成为治疗门静脉高压的首选术式。Objective：To observe the clinical efficacy of proximal spleno-renal shunt（PSS） plus pericardial devascularization（PD） in treatment of patients with portal hypertension.Methods：One hundred and twelve patients with portal hypertension were managed by PSS plus PD（31 cases） and PD only（81 cases）.The changes in the free portal pressure before and after surgery as well as the short and long term efficacy were observed.Results：The free portal pressure decreased more obviously in the combination therapy group than in the PD group（P〈0.01）;there were no significant differences in the mortality rate,recent re-bleeding rate and incidence of hepatic encephalopathy between the two groups（P〈0.05）;the incidence of long-term re-bleeding and ascites in the combination therapy group was lower than that in the PD group（P〉0.05）;the incidence of long-term hepatic encephalopathy had no significant difference between the two groups（P〉0.05）.Conclusions：PSS plus PD is the choice therapy for portal hypertension combined with hemorrhage,which integrates the advantages of PSS and PD,decreasing the incidence frebreeding and avoiding the increase of hepatic encephalopathy.

关 键 词：高血压 门静脉 脾肾分流术 贲门周围血管离断术 

分 类 号：R654.3[医药卫生—外科学]