贲周血管离断联合食管下端离断再钉合术治疗食管胃底静脉曲张出血疗效观察  

Curative efficacy observation to re-stapling technique after pericardial-esophagogastric devascularization in patient with esophageal variceal bleeding

作　　者：李杰[1] 陈萃[1] 宋子华[1] 

机构地区：[1]三峡大学第一临床医学院普外科,湖北宜昌443000

出　　处：《腹部外科》2013年第2期112-114,共3页Journal of Abdominal Surgery

摘　　要：目的探讨贲门周血管离断联合食管下端离断再钉合术治疗食管胃底静脉曲张出血的疗效。方法对2008年1月至2011年12月在我院行贲门周血管离断联合食管下端离断再钉合术治疗的58例门静脉高压症食管胃底静脉曲张出血的临床资料进行回顾性分析。结果58例均为肝炎（乙型病毒性肝炎或丙型病毒性肝炎）后肝硬化门静脉高压症患者，Child肝功能分级：A级35例，B级20例，C级3例。随访3个月，其中术后发生吻合口瘘5例，吻合狭窄2例，继发出血2例，死亡3例，门静脉系统血栓1例。结论该手术对近期继发出血疗效令人满意，如果术中及术后处理得当，以减少或避免其他并发症的发生，是治疗门静脉高压症食管胃底静脉曲张出血的一种理想术式。Objective To explore the curative efficacy observation to re-stapling technique after pericardial-esophagogastric devascularization in patient with esophageal variceal bleeding. Methods From January 2008 to December 2011, 58 cases of portal hypertension associated with esophageal variceal bleeding underwent re-stapling technique after pericardial-esophagogastric devascularization in our hospital, and their clinical data were reviewed and analyzed. Results All 58 cases were diagnosed post-hepatitis （hepatitis B or hepatitis C） liver cirrhosis and portal hypertension and Child liver function classification was as follows： grade A in 35 cases, grade B in 20 cases, and grade C in 3 cases. During 3 months follow-up period in post-operation, anastomotic fistula occurred in 5 cases, anastomotic stenosis in 2 cases, secondary hemorrhage in 2 cases, and death in 3 cases, as well portal vein thrombosis in 1 case. Conclusion Re-stapling technique after pericardial-esophagogastric devascularization is effective for controlling secondary bleeding. Properly intra-operative and post - operative management can help to reduce or avoid occurrence of complications, suggesting it is an ideal method in patient with esophageal variceal bleeding associated with portal hypertension.

关 键 词：高血压 门静脉 食管和胃静脉曲张 手术后并发症 

分 类 号：R571.3[医药卫生—消化系统]