门脉高压上消化道大出血断流术中保留贲门的临床探讨  

Clinical study of devascularization operation reserving cardia of upper gastrointestinal hemorrhage with portal hypertension

作　　者：仝麟龙[1] 仝现州[1] TONG Lin - long;TONG Xian - zhou(Zhengzhou People＇s Hospital, Zhengzhou 450003, Chin)

机构地区：[1]郑州人民医院普外三科,郑州450003

出　　处：《医药论坛杂志》2018年第5期54-55,58,共3页Journal of Medical Forum

摘　　要：目的探讨肝炎后肝硬化门静脉高压症上消化道大出血门—奇断流术中保留贲门术式的治疗价值。方法随机对肝炎后肝硬化并门静脉高压症上消化道出血的96例病人分为治疗组和对照组。治疗组51例,病人行脾切除、门—奇静脉断流采用保留贲门的食管端端吻合术。对照组45例,行脾切除、门—奇静脉断流胃食管吻合术。观察术后吻合口瘘、吻合口狭窄、吻合口出血、吻合口溃疡发生率。用SAS统计软件分析处理。结果治疗组51例,围手术期无吻合口瘘,术后3、6、12、18、24个月,吞钡透视吻合口狭窄2例,6、12、18、24个月,胃镜检查吻合口溃疡6例。对照组45例,围手术期吻合口瘘3例,吻合口狭窄13例,吻合口溃疡出血16例。结论门脉高压上消化道大出血断流术中保留贲门,对于降低术后吻合口瘘、吻合口狭窄、吻合口出血、吻合口溃疡发生率具有临床意义。Objective To explore the therapeutic value of reserving cardia in devascularization operation to upper gastrointestinal hemorrhage of patients with posthepatitic cirrhosis and portal hypertension. Methods Totall 96 patients suffering from upper gastrointestinal hemorrhage with posthepatitic cirrhosis and portal hypertension were randomly divided into treatment group and control group,There are 51 cases in the treatment group,the patients underwent splenectomy and devascularization with preservation of cardia. 45 cases in the control group,the patients underwent only splenectomy and devascularization. The incidence of postoperative anastomotic leakage,anastomotic stenosis,anastomotic bleeding and anastomotic ulcer was observed. Using SAS statistical software was used to analyze and process the data.Results There was no anastomotic fistula in perioperative period in 51 cases of the treatment group,2 cases of anastomotic stenosis by X-ray barium meal examination in 3 months,6 months,12 months,18 months,24 months after operation,6 cases of anastomosis ulcer in 6 months,12 months,18 months,24 months after operation. There were 3 cases of anastomotic stoma fistula in perioperative period,13 cases of anastomotic stenosis,16 cases of anastomotic ulcer bleeding in 45 cases of the control group. Conclusion The retention of gastric cardia in devascularization operation of upper gastrointestinal hemorrhage with portal hypertension has clinical significance for decreasing the incidence of anastomotic leakage,anastomotic stenosis,anastomotic bleeding and anastomotic ulcer after operation.

关 键 词：门静脉高压 断流术 贲门 

分 类 号：R61[医药卫生—外科学]