规范化贲门周围血管离断联合大网膜包肾术对门静脉高压症疗效的影响  

Standardized pericardial devascularization with omentorenopexy and its effects on portal hypertension

作　　者：邹卫龙[1] 杨镇[1] 孙政[1] 梁志鹏[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院综合2楼外科,430030

出　　处：《消化外科》2004年第2期81-83,共3页Journal of Digestive Surgery

基　　金：国家自然科学基金资助项目 (No .3 0 170 92 0 )

摘　　要：目的　评价规范化贲门周围血管离断术联合大网膜包肾术对门静脉高压症病人手术后近期和远期疗效的影响。方法　对 1994年 6月～ 2 0 0 2年 6月 ,我院 195例门静脉高压症病人接受规范化贲门周围血管离断术联合大网膜包肾术 ( 136例 )和没有联合包肾术 ( 59例 )手术后 30d内发热、脾窝渗液和手术 30d后上消化道再出血、胃黏膜损伤及肝性脑病等并发症发生情况进行比较。结果大网膜包肾组病人手术近期脾窝渗液和发热率明显低于未联合包肾组 (P <0 .0 5) ;包肾组病人随访期间上消化道再出血率较低 ( 3.7%和 5.1% ,P <0 .0 5)、门静脉高压性胃黏膜损伤明显减轻 ( 2 9 4 %和 6 6 .1% ,P <0 .0 1) ;但并不增加肝性脑病发生率 (P≥ 0 .0 5)。结论　联合大网膜包肾术可以有效降低手术后近期和远期并发症的发生 。Objective To evaluate the effect of standarized per icardial devascularization(sPCDV) combined with omentorenopexy(ORP) on port al hype rtension. Methods From Jun. 1994 to Jun. 2002, 195 cases of por tal hypertension with sPCDV wee studied. The early complications such as febrile and splenic fossa, as well as long-term complications such as recurrent bleedi ng, hypertensive gastropathy, and encephalopathy were compared between 136 cases of patients with ORP and 59 cases of patients without ORP. Results The patients undergoing sPCDV with ORP showed decreased exudate in splenic fossa and febrile (P<0.05, respectively). Rate of recurrent bleeding (3.7% vs 5.1%, P<0.05) and portal hypertensive gastropathy (29.4% vs 6 6.1%, P<0.01) was reduced markedly in group with ORP, while the risk of hepa tic encephalopathy was not increased(P≥0 05). Conclusions Standardized pericardial devascularization combined with omentorenopexy appears to be effective in attenuating early and long-term complications of portal hyp ertension and improving the efficacy.

关 键 词：门静脉高压症 大网膜包肾术 贲门周围血管离断术 手术后并发症 诊断 

分 类 号：R657.34[医药卫生—外科学]