腹腔镜断流联合内镜套扎与腹腔镜改良Sugiura手术治疗门静脉高压症的临床研究  

Clinical Study of Laparoscopic Devascularization Combined with Endoscopic Esophageal Varix Ligation and Laparoscopic Modified Sugiura Surgery for Treatment of Portal Hypertension

作　　者：冯以斌 张光亚[1] 别玉坤[1] 邱伟[1] 

机构地区：[1]陕西省安康市中心医院普外科,陕西安康725000

出　　处：《医学临床研究》2016年第12期2374-2376,共3页Journal of Clinical Research

摘　　要：【目的】探讨腹腔镜断流联合内镜食管静脉套扎与腹腔镜改良Sugiura手术治疗门静脉高压症的临床效果。【方法】将103例门静脉高压症患者随机分为A组（行腹腔镜断流联合食管静脉套扎术，n=55）和B组（行腹腔镜改良Sugiura手术，n=48），比较两组手术时间、术后肛门排气时间、术后住院时间、肝功能Child-Pugh分级以及食管胃底静脉曲张程度等指标。【结果】A组手术时间、术后肛门排气时间、术后住院时间短于B组，差异有统计学意义（P〈0．05），两组术中出血量、术后引流量无明显差异（P〉0．05）；两组术后6个月食管静脉曲张程度、肝功能分级均较术前明显改善，A组Child-Pugh分级A级患者所占比例高于B组，肝性脑病发病率低于B组，差异均有统计学意义（均P〈0．05）。【结论】腹腔镜断流联合食管静脉套扎治疗门静脉高压症具有手术时间短，术后肝、肠功能恢复较好以及术后肝性脑病发生率低的优点，值得临床推广应用。[Objective]To explore the clinical effect of laparoscopic devascularization combined with endoscopic esophageal varix ligation（EVL） and laparoscopie modified Sugiura surgery for the treatment of portal hypertension.[Methods]A total of 103 patients with portal hypertension was randomly divided into two groups： ,the Group A （underwent laparoscopic devascu- larization combined with endoscopic esophageal varix ligation（EVL） （ n = 55） and the Group B （underwent laparoscopic Sug- Jura operatio（ n =48）. The operation time, postoperative anal exhaust time, postoperative hospital stay, liver function Child- Pugh grade and esophageal varices were compared between the two groups.[ResultslCompared with those of the Group B, the operative time, hospital stay and postoperative exhaust time in the Group A were shorter , the difference was statistically significant （ P 〈0.05） and there was no significant difference in blood loss and volume of drainage between the two groups （ P〈 0.05）. Six months after the operation, the esophageal varices degree and Child-Pugh classification in the two groups were better than that of pre-operation. Patients with Child-Pugh classification grade A in the Group A were more than that in the Group B （ P =0.0300）, and the incidence Of hepatic eneephalopathy was lower than that of the Group B, the difference was statistically significant （ P 〈0,05）.[Conelusion]Laparoseopie devascularization combined with endoscopic esophageal varix ligation（EVL） for the treatment of portal hypertension has advantages of shorter operation time, better recovery of liver and intestinal function with lower incidence of hepatic encephalopathy after operation,

关 键 词：高血压 门静脉/外科学 腹腔镜检查 结扎术 内窥镜检查 食管和胃静脉曲张 

分 类 号：R657.34[医药卫生—外科学]