近端脾腔分流术治疗食管静脉曲张出血的远期疗效  

LONGTERM FOLLOWUP OF EFFICACY OF THE PROXIMAL SPLENOCAVAL SHUNT FOR TREATMENT OF BLEEDING ESOPHAGEAL VARICES.

作　　者：钱志祥[1] 应嘉钧[1] 何毓椿 

机构地区：[1]浙江省嘉兴市第一医院外科,嘉兴314000

出　　处：《肝胆外科杂志》2002年第3期190-192,共3页Journal of Hepatobiliary Surgery

摘　　要：目的　探讨近端脾腔静脉分流术治疗食管静脉曲张出血的远期疗效。方法　自 1978～ 1996年 2 4例近端脾腔静脉分流术治疗食管静脉曲张出血 ,全组均为血吸虫病性肝硬化 ,作 19年远期随访。每年由基层保健站随访 ,每 5～ 10年由外科医生对其存活率、死亡原因和并发症登记。结果　死亡 1例 (4.2 % ) ,除 1例失访外 ,余 2 2例 (95 .6 % )随访最长 19年 ,平均为18年 ;1例 (4.3% )复发出血 ,1例 (4.3% )发生脑病。存活率 5～ 10年 ,～ 15年 ,～ 2 0年分别为 87%、78.3% ,74 %。结论　近端脾腔静脉分流术治疗食管静脉曲张出血者为一安全有效的手术方法 ,我们推荐其广泛使用。Objective To probe the long-term efficacy of the proximal splenocaval shunt for treatment of bleeding esophageal varices,including a briefly introduced for the mode of splenocaval shunt.Methods From 1978-1996,24 patients with bleeding esophageal varices treated by the proximal splenocal shunt.All Patientss were schistosomial cirrhosis.Patients are regularly followed by the medical staff of cooperative health care stations annually and by the surgeon every5-10 years postoperative to register for the survival rate,courses of death and postoperative complications.Results One patient died.Eliminating the one patient lost to follow-up,there remained 22 patients(95.6%) were follow-up for and average of 18 years with the longest time 19 years.One patient(4.2%) experienced rebleeding.One patient(4.2%)has manifested encephalopathy.The survival rate of 5-10,-15,-20 years were 95.6%,78.3%,74% respectively.Conclusion The proximal splenocaval shunt is safe and effective operation for the treatment of the esophageal varices bleeding.We recommend that it be more widerly used.

关 键 词：食管静脉曲张 出血 近端脾腔静脉分流术 血吸虫病性肝硬化 

分 类 号：R657.3[医药卫生—外科学]