TIPS、改良Sugiura术和TIPS加改良Sugiura术治疗门静脉高压症的疗效观察  

Comparison of TIPS, a modified Sugiura procedure and TIPS plus a modified Sugiura procedure for portal hypertension

作　　者：吴性江[1] 曹建民[1] 吴学豪[1] 韩建明[1] 黎介寿[1] 

机构地区：[1]南京军区南京总医院外科,210002

出　　处：《中华外科杂志》2000年第2期98-100,共3页Chinese Journal of Surgery

摘　　要：目的　探讨TIPS、改良Sugiura术和TIPS加改良Sugiura术治疗门静脉高压症的临床疗效。　方法　对 90例门静脉高压症患者分别行TIPS(Ⅰ组 )、改良Sugiura(Ⅱ组 )和TIPS加改良Sugiura术 (Ⅲ组 )治疗。　结果　Ⅰ、Ⅱ和Ⅲ组近期并发症分别为 2 3 3 3 %、3 0 0 0 %和 2 0 0 0 % ,其中 ,出血复发率为 6 67%、10 0 0 %和 0 % ,肝性脑病为 16 67%、0 %和 13 3 3 % ,Ⅰ组病死率为 3 3 3 %。术后 1～ 3 6个月随访 ,Ⅰ、Ⅱ和Ⅲ组出血复发率分别为 3 4 4 8%、3 3 3 3 %和 3 3 3 % ;肝性脑病分别为 17 2 4 %、3 3 3 %和 3 3 3 % ,病死率分别为 2 0 69%、13 3 3 %和 3 3 3 %。Ⅲ组分流道通畅率高于Ⅰ组。　结论　TIPS与改良Sugiura术联合运用能有效地防治食管静脉曲张出血。Objective Transjugular intrahepatic portosystemic shunts (TIPS), a modified Sugiura procedure and TIPS plus a modified Sugiura procedure were compared to evaluate their clinical results in treatment of portal hypertension. Methods Ninety patients with portal hypertension respectively underwen TIPS (group Ⅰ, n =30), a modified Sugiura procedure (group Ⅱ, n =30) and TIPS plus a modiefied Sugiura procedure (group Ⅲ, n =30 ). The rates of rebleeding and encephalopathy, and the mortality of patients with portal hypertension were observed. Results The early postoperative complications were observed in 23 33% of the patients in group Ⅰ, in 30 0% of those in group Ⅱ, and in 20 0% of those in group Ⅲ. The early postoperative rates of rebleeding were 6 67% in group Ⅰ, 10% in group Ⅱ, and 0% in group Ⅲ. Hepatic encephalopathy was seen in 16 67% of the patients in group Ⅰ, 0% in group Ⅱ and 13 33% in group Ⅲ. The early mortality was 3 33% in group Ⅰ. During follow up for 1-36 months, the rates of rebleeding were 34 48% in group Ⅰ, 33 33% in group Ⅱ, and 3 33% in group Ⅲ. The rates of encephalopathy and mortality were respectively 17 20% and 20 69% in group Ⅰ, 3 33% and 13 33% in group Ⅱ, 3 33% and 3 33% in group Ⅲ. The shunt patency in group Ⅲ was higher than that in group Ⅰ. Conclusion Combination of TIPS and a modified Sugiura procedure can be effective to prevent and treat variceal bleeding.

关 键 词：门脉高压症 TIPS术 SUGIURA术 疗效 

分 类 号：R657.34[医药卫生—外科学]