贲门周围血管缝扎术治疗食管胃底曲张静脉破裂出血  

A modified Hassab procedure in the treatment of acute esophageal variceal bleeding

作　　者：王其[1] 刘飞龙[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

出　　处：《国际外科学杂志》2014年第7期454-457,共4页International Journal of Surgery

基　　金：基金项目：卫生部行业基金（No.201002015）

摘　　要：目的 探讨贲门周围血管缝扎术在治疗非手术治疗失败的肝硬化引起的食管胃底曲张静脉破裂出血中的作用.方法 1990年1月-2009年12月,136例非手术治疗失败的肝硬化所致食管胃底曲张静脉破裂出血患者接受了贲门周围血管缝扎术.我们对上述病例的围手术期情况及远期疗效进行了回顾性分析.结果 急诊手术止血成功率为97.8％（133/136）,围手术期病死率为5.1％ （7/136）.术后3年及5年再出血率分别为7.0％ （9/129）及13.2％ （17/129）;术后3年及5年及生存率分别为91.5％ （118/129）及79.8％ （103/129）.结论 贲门周围血管缝扎术治疗肝硬化合并食管胃底曲张静脉破裂出血具有较好的手术安全性及疗效.Objective Acute esophageal variceal bleeding is one of the most dreadful complications of cirrhotic portal hypertension.This study evaluated a modified gastro-esophageal decongestion （MGED） procedure in the management of acute variceal bleeding that could not be controlled by drugs and/or endoscopic therapy.Methods A MGED procedure was performed in 136 patients with uncontrollable acute variceal bleeding by drugs and/or endoscopic therapy.The perioperative and long-term outcome of these patients were retrospectively studied.Resluts Immediate control of variceal bleeding was achived in 97.8% （133/136） patients.Perioperative mortality occurred in 5.1% （7/136） patients.The 3-year and 5-year rebleed rate was 7.0% （9/129） and 13.2%,respectively.The 3-year and 5-year overall survival rate was 91.5% （118/129） and 79.8% （103/129）,respectively.Conclusions In this study,the MGED procedure was an effective life-saving procedure in controlling acute esophageal variceal bleeding for its safe,simple and less time-consuming advantages.

关 键 词：肝硬化 食管和胃静脉曲张 断流术 

分 类 号：R657.3[医药卫生—外科学]