贲门周围血管缝扎术治疗肝硬化门静脉高压临床分析  

Clinical analysis of cardiac peripheral vascular suture ligation in the treatment of cirrhotic portal hypertension

作　　者：宋黎明[1] 马秀现[1] 孙玉岭[1] 李德旭[1] 冯留顺[1] 

机构地区：[1]郑州大学第一附属医院肝胆外科,450052

出　　处：《中国实用医刊》2014年第8期10-12,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨贲门周围血管缝扎术治疗肝硬化门静脉高压的临床疗效。方法回顾性分析2006年7月至2010年9月收治的门静脉高压症185例患者的临床资料，其q-68例行贲门周围血管断流术，117例行贲门周围血管缝扎术。通过对两种治疗方式的临床疗效的观察，术q-自由门静脉压（FPP）的动态监测，对术中、术后各临床观察指标，术后远期并发症及生存率行对比研究。结果术后两组FPP均下降，缝扎术组与断流术组比较差异有统计学意义（P〈0．01），FPP下降幅度：缝扎术组〉断流术组。对照两种手术方式术中及术后各临床指标，两组间各指标比较差异均有统计学意义（P均〈0．01）。缝扎术组及断流术组均无手术死亡病例，断流术组再出血率高于缝扎术组，断流术组与缝扎组肝性脑病发生率相近，断流术组3年生存率低于缝扎术组。结论贲门周围血管缝扎术能降低患者FPP，同时能够有效减少食管及胃底部曲张静脉破裂再出血率，降低术后并发症发生率及病死率。Objective To investigate the clinical effect of cardiac peripheral vascular suture ligation on patients with portal hypertension. Methods From July 2006 to September 2010, the clinical data of 185 patients with portal hypertension were retrospectively analyzed. Sixty-eight patients w^re given gastroesophageal devasculariztion, 117 patients were given gastroesophageal vessel suture ligation. By ob- servation of the clinical efficacy of the two kinds of treatment and dynamic mornitor of the free portal pres- sure during operation, the clinical observation indexes and postoperative long-term complications and sur- vival rate were compared. Results The FPP in the two postoperation groups all decreased, there was significant difference between suture group and devascularization group（P 〈 0. 01 ）. FPP decline range： suture group 〉 devascularization group. There were significant differences in the clinical parameters dur- ing and after the operations（P 〈0. 01 ）. There was no operation death case in suture group or devascular- ization group. The rebleeding rate in devascularization group was higher than that in the suture group, the incidences of hepatic eneephalopathy in the two groups were basically the same; the 3 years survival rate in the devase.ularization group was lower than that in the suture group. Conclusions Cardiac peripheral vascular sutur~ can reduce the FPP, effectively reduce the rebleeding rate of the esophageal and gastric fundus vai＇ie0se vein, and reduce the incidence of postoperative complications and mortality rate.

关 键 词：门静脉高压 断流术 血管缝扎 

分 类 号：R657.3[医药卫生—外科学]