CAJ | 학술논문

目的比较贲门周围血管离断术与改良Sugiura手术治疗门静脉高压症的疗效.方法对自1990年1月至2008年6月在我院行断流术治疗门静脉高压症的236例病人(其中贲门周围血管离断术147例,改良Sugiura手术89例)进行回顾性分析.结果贲门周围血管离断术治疗组围手术期病死率为8.2%,围手术期再出血率为2%.改良Sugiura手术治疗组围手术期病死率为7.9%,围手术期再出血率为3.4%.贲门周围血管离断术组随访率为91.9%,随访时间为6个月至19年,平均随访时间5.0年.术后累积出血率分别为5.7%(1年)、15.2%(3年)和25.5%(5年);累积生存率分别为87.8%(1年)、79.1%(3年)、69.7%(5年).改良Sugiura手术组随访率为87.8%,随访时间为6个月至19年,平均随访时间5.0年.术后累积出血率分别为6.9%(1年)、16.3%(3年)和29.5%(5年);累积生存率分别为95.8%(1年)、85.0%(3年)和76.9%(5年).结论贲门周围血管离断术与改良Sugiura手术两种治疗在围手术期病死率、围手术期再出血率、术后累积出血率、术后累积病死率及病死原因构成方面无统计学差异.
목적 비교분문주위혈관리단술여개량Sugiura수술치료문정맥고압증적료효.방법 대자1990년1월지2008년6월재아원행단류술치료문정맥고압증적236례병인(기중분문주위혈관리단술147례,개량Sugiura수술89례)진행회고성분석.결과 분문주위혈관리단술치료조위수술기병사솔위8.2%,위수술기재출혈솔위2%.개량Sugiura수술치료조위수술기병사솔위7.9%,위수술기재출혈솔위3.4%.분문주위혈관리단술조수방솔위91.9%,수방시간위6개월지19년,평균수방시간5.0년.술후루적출혈솔분별위5.7%(1년)、15.2%(3년)화25.5%(5년);루적생존솔분별위87.8%(1년)、79.1%(3년)、69.7%(5년).개량Sugiura수술조수방솔위87.8%,수방시간위6개월지19년,평균수방시간5.0년.술후루적출혈솔분별위6.9%(1년)、16.3%(3년)화29.5%(5년);루적생존솔분별위95.8%(1년)、85.0%(3년)화76.9%(5년).결론 분문주위혈관리단술여개량Sugiura수술량충치료재위수술기병사솔、위수술기재출혈솔、술후루적출혈솔、술후루적병사솔급병사원인구성방면무통계학차이.
Objective To compare the effect of pericardial devascularization with that of the modified Sugiura procedure in management of portal hypertension. Methods From 1990 to 2008, 236patients with portal hypertension underwent operations including pericardial devascularization in 147and modified Sugiura in 89 in our hospital. Results There were 12 perioperative deaths (8.2 % ), and 2 rebleedings (2 % ) in the pericardial devascularization group, and 7 perioperative deaths (7.9 % ) and 2 rebleedings(3.4 % ) in the modified Sugiura group. The follow-up rate was 91.9 % in the pericardial devascularization group and 87.8% in the modified Sugiura group respectively, in a period from 6 months to 19 years. The 1-, 3-and 5-year rebleeding rates were 5.7%,15.2% and 25.5% in the pericardial devascularization group and 6.9%, 16.3%, 29.5 % in the modified Sugiura group, respectively. The 1-, 3- and 5-year survival rates were 87.8% ,79.1% and 69.7% in the pericardial devascularization group and 95.8 %,85.0%, 76.9 % in the modified Sugiura group, respectively. Conclusion Modified Sugiura procedure and pericardial devascularization have differences in perioperative mortality as well as rebleeding and survival rates.