介入治疗与手术治疗门静脉血栓的效果  

Effect of interventional therapy and surgical treatment on portal vein thrombosis

作　　者：吴万波[1,2] 魏云海[1,2] 魏锋[1,2] 慎华平[1,2] 张明[1,2] 朱晓伟[1,2] 

机构地区：[1]浙江省湖州市中心医院普外科,浙江湖州313000 [2]浙江省湖州市中心医院血管外科,浙江湖州313000

出　　处：《中国现代医生》2016年第21期93-95,98,共4页China Modern Doctor

基　　金：浙江省科技计划项目(2014C33137)

摘　　要：目的探讨介入治疗与手术治疗门静脉血栓的效果。方法选取我院2000年3月~2014年3月的108例门静脉血栓患者,随机分为介入治疗组与手术治疗组各54例,介入治疗组采用静脉切开取栓术进行治疗,手术治疗组采用腹腔镜手术治疗,观察两组患者的治疗成功率、肝性脑病发生率、死亡率及门静脉压力变化。结果介入治疗组和手术治疗组的患者均操作成功。两组患者手术后的门静脉压力与手术前比较,差异有统计学意义（P〈0.05）;介入治疗组手术后的门静脉压力明显低于手术治疗组,差异有统计学意义（P〈0.05）;随访期内介入治疗组死亡率与与手术治疗组死亡率比较,差异有统计学意义（P〈0.05）,其2年累计生存率分别为98.1%、81.5%,差异有统计学意义（P〈0.05）;随访期内介入治疗组有8例出现肝性脑病,手术治疗组有14例出现肝性脑病,两组肝性脑病发生率分别为14.8%、25.9%,差异有统计学意义（χ^2=5.252,P〈0.05）。结论对门静脉血栓患者进行介入治疗不仅手术安全,手术后生存率比较高,是一种理想介入治疗方法。Objective To study the effect of interventional therapy and surgical treatment for portal vein thrombosis.Methods In our hospital from March 2000 to March 2014, 108 cases of portal vein thrombosis were studied and divided into interventional treatment group and surgical treatment group, each of 54 cases, the interventional therapy group was treated with venotomy embolectomy, while surgical treatment group was treated with laparoscopic surgery, the treatment success rate, the incidence of hepatic encephalopathy, mortality and portal venous pressure changes were observed in two groups on patients. Results All the patients in the intervention group and the operation group were operated successfully. The difference of portal venous pressure of two groups of patients after surgery and before surgery was statistically significant（P〈0.05）; The portal vein pressure after surgery of interventional treatment group was significantly lower than the surgery treatment group, with statistically significant difference（P〈0.05）; the interventional treatment group and surgical treatment group had obvious difference with the mortality rate and mortality during follow-up intervention（P〈0.05）, the 2 years cumulative survival rates of two groups were 98.1% and 81.5%, with statistically significant difference（ P〈0. 05）; the treatment group had 8 cases of hepatic encephalopathy in the follow-up period,there were 14 cases of surgical treatment of hepatic encephalopathy, the incidence of hepatic encephalopathy of two groups were 14.8% and 25.9%, with statistically significant difference（χ^2=5.252, P〈0.05）. Conclusion Portal vein thrombosis in patients of interventional treatment is not only the safety of the surgery and postoperative survival rate is relatively higher, it is a kind of ideal interventional therapy.

关 键 词：门静脉血栓 介入治疗 手术治疗 门静脉压力 

分 类 号：R657.34[医药卫生—外科学]