CAJ | 학술논문

目的探讨选择性脾胃区减断分流术治疗肝硬化门静脉高压症的临床应用.方法 2000年9月至2008年6月间采用选择性脾胃区减断分流术治疗门静脉高压症44例.其中29例随访12～85个月,平均44个月.结果 (1)无术中大出血和病死病例,区域性减压显著;(2)术后近期轻度脾梗塞3例,并发乳糜漏3例;(3)近期肝性脑病发生率2.27%(1/44),再发出血率0%;远期肝性脑病发生率3.45%(1/29),再发出血率3.45%(1/29);(4)远期脾脏显著缩小,血小板显著升高(P<0.01).结论选择性脾胃区减断分流术疗效可靠,可作为治疗门静脉高压症的理想术式.
목적 탐토선택성비위구감단분류술치료간경화문정맥고압증적림상응용.방법 2000년9월지2008년6월간채용선택성비위구감단분류술치료문정맥고압증44례.기중29례수방12～85개월,평균44개월.결과 (1)무술중대출혈화병사병례,구역성감압현저;(2)술후근기경도비경새3례,병발유미루3례;(3)근기간성뇌병발생솔2.27%(1/44),재발출혈솔0%;원기간성뇌병발생솔3.45%(1/29),재발출혈솔3.45%(1/29);(4)원기비장현저축소,혈소판현저승고(P<0.01).결론 선택성비위구감단분류술료효가고,가작위치료문정맥고압증적이상술식.
Objective To evaluate the curative effect of selective decongestive devascularization shunt of gastrosplenic region(SDDS-GSR) for the treatment of portal hypertension. Methods From September 2000 to June 2008, 44 patients with portal hypertension had received SDDS-GSR in our hospital. Twenty-nine of them had been followed up for 12-85 months (mean=44months). Results Operative mortality was 0 %. Mesenteric area pressure(33.82±5.12 cm H_2O) was higher than splenic area pressure(24.57±4.63 cm H_2O)soon after the operation finished(P<0.01). No re-bleeding ca-ses were found, and the encephalopathy occurred in 2.27% of the patients in the early stage of post-operation. However, the rates of 3.45% for re-bleeding and 3.45% for encephalopathy were noticed in long-term follow-up. The 1-, 3- and 5-year survival were 100%, 95% and 95%, respectively. Dur-ing the long-term follow-up, the platelet counts markedly increased from (49.2±21.8 × 10~9/L) of preoperative value to (77.2±29.5×10~9/L) (P<0.01), while spleen size was significantly reduced.Conclusion SDDS-GSR is a reliable and reasonable surgical procedure for the management of portal hypertension.