晚期血吸虫病脾切除加周围血管离断术后再出血的手术治疗  

Operation for postoperative re-hemorrhage after splenectomy with periesoph-agogastric devascularization for advanced schistosomiasis

作　　者：王青山[1] 王家凤[1] 张广艳[1] 

机构地区：[1]湖北省江陵县人民医院,江陵434100

出　　处：《中国血吸虫病防治杂志》2014年第1期101-102,共2页Chinese Journal of Schistosomiasis Control

摘　　要：目的观察晚期血吸虫病门静脉高压脾切除术加周围血管离断术后再出血的手术治疗效果。方法2002年10月-2011年10月，采用左侧经胸食管切开曲张静脉缝扎加贲门周围血管再离断术（部分患者加做胃底大弯侧部分切除术），治疗晚期血吸虫病门静脉高压症脾切除加断流术后再出血的患者。随访1～9年，观察疗效。结果共手术治疗43例，其中择期手术27例，急诊手术16例，平均随访时间为6．8年，止血率为100％。术后死亡1例，死亡原因为从事重体力劳动后再出血。2例解黑色柏油样大便，均经保守治疗后消失。其余病例均恢复良好。结论左侧经胸食管切开曲张静脉缝扎加贲门周围血管再离断术治疗晚期血吸虫病门静脉高压症脾切除加断流术后再出血，效果满意。Objective To evaluate the efficacy of the operation in the treatment of postoperative re-hemorrhage after splenec tomy with periesophagogastric devaseularization for advanced schistosomiasis. Methods Forty-three re-hemorrhage patients, who received varicose ligation combined with perieardial devascularization through left thoracic cavity with esophageal incision from Oc tober 2002 to October 2011, after splenectomy with periesophagogastric devaseularization due to portal vein hypertension, were in- vestigated retrospectively and followed up for 1 to 9 years. Results Forty-three re-hemorrhage patients operated included 27 cas- es of selective operation and 16 cases of emergency operation. The mean follow-up time was 6.8 years. The hemostasis rate was 100%. One died after the operation because of engaging in heavy labor, two had melena and were completely relived with the con servative treatment, and all the rest had a good recovery. Conclusion The operation of varicose ligation combined with pericardi al devascularization through left thoracic cavity with esophageal incision in the treatment of postoperative re-hemorrhage after sple nectomy with periesophagogastric devascularization for advanced schistosomiasis has a satisfied efficacy.

关 键 词：晚期血吸虫病 门静脉高压症 术后再出血 疗效 

分 类 号：R532.21[医药卫生—内科学]