联合断流术治疗食管胃底静脉出血51例分析  

Combined devascularization operation for portal hypertension： a report of 51 cases

作　　者：张磊[1] 于鑫[2] 章锐[1] 刘飞龙[1] 张万广[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院肝脏外科中心,武汉430030 [2]山东省泰安市中心医院外科

出　　处：《腹部外科》2014年第2期105-107,共3页Journal of Abdominal Surgery

基　　金：卫生部部属医院临床学科重点项目（2007-353）;湖北省肝脏外科医学研究中心项目

摘　　要：目的探讨联合断流术治疗门静脉高压症并食管胃底静脉曲张的效果。方法对2005年1月至2013年6月间采用择期联合断流术的51例肝硬化门静脉高压症临床资料进行回顾性分析。结果所有患者均无手术死亡。平均手术时间为（3．6±0．8）h，输血量为（547±120）ml，术后平均住院天数为（10．3±3．2）d。胸腔积液6例（11．8％），腹水7例（13．7N），门静脉血栓12例（23．5％），均无吻合口瘘和吻合口狭窄。肝性脑病0例，再出血率3．9％（2／51）。术后6个月随访，食管胃底曲张静脉消失35例（68．6％），显著改善15例（29．4％），无明显变化者1例（2．O％）。结论联合断流术可以有效治疗食管胃底静脉曲张，并发症少，再出血率低，是一种值得推广的治疗门静脉高压症的手术方式。Objective To explore the safety and efficaeies of combined devascularization operation for esophagogastric varices in patients with portal hypertension due to liver cirrhosis. Methods The clinical data of 51 cases with portal hypertension undergoing combined devascularization operation from January 2005 to June 2013 were analyzed. Results There was no occurrence of intrao- perative mortality. The mean operative duration was 3.6 -＋ 0. 8 hours, transfusion volume 547 ＋ 120 ml and mean postoperative hospital slay 10. 3 ＋ 3. 2 days. The major complications included pulmonary ef- fusion （n = 6, 11.8 %）, transient ascites （n = 7, 13. 7 ~） and asymptomatic portal vein thrombosis （n = 12, 23. 5%）. Rebleeding （n= 2, 3.9%） was documented during a follow-up period of 6 months. Postoperative endoscopy revealed that varices improved significantly from severe to mild （29. 4% ） and even disappeared （68.6%）. Conclusions With lower rates of complications and bleeding, combined devascularization operation is safe and efficacious for esophagogastric varices in patients with portal hypertension due to liver cirrhosis.

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：R605[医药卫生—外科学]