CAJ | 학술논문

目的：观察晚期血吸虫病门静脉高压脾切除术加周围血管离断术后再出血的手术治疗效果。方法2002年10月-2011年10月，采用左侧经胸食管切开曲张静脉缝扎加贲门周围血管再离断术（部分患者加做胃底大弯侧部分切除术），治疗晚期血吸虫病门静脉高压症脾切除加断流术后再出血的患者。随访1～9年，观察疗效。结果共手术治疗43例，其中择期手术27例，急诊手术16例，平均随访时间为6.8年，止血率为100%。术后死亡1例，死亡原因为从事重体力劳动后再出血。2例解黑色柏油样大便，均经保守治疗后消失。其余病例均恢复良好。结论左侧经胸食管切开曲张静脉缝扎加贲门周围血管再离断术治疗晚期血吸虫病门静脉高压症脾切除加断流术后再出血，效果满意。
목적：관찰만기혈흡충병문정맥고압비절제술가주위혈관리단술후재출혈적수술치료효과。방법2002년10월-2011년10월，채용좌측경흉식관절개곡장정맥봉찰가분문주위혈관재리단술（부분환자가주위저대만측부분절제술），치료만기혈흡충병문정맥고압증비절제가단류술후재출혈적환자。수방1～9년，관찰료효。결과공수술치료43례，기중택기수술27례，급진수술16례，평균수방시간위6.8년，지혈솔위100%。술후사망1례，사망원인위종사중체력노동후재출혈。2예해흑색백유양대편，균경보수치료후소실。기여병례균회복량호。결론좌측경흉식관절개곡장정맥봉찰가분문주위혈관재리단술치료만기혈흡충병문정맥고압증비절제가단류술후재출혈，효과만의。
Objective To evaluate the efficacy of the operation in the treatment of postoperative re-hemorrhage after splenec-tomy with periesophagogastric devascularization for advanced schistosomiasis. Methods Forty-three re-hemorrhage patients,who received varicose ligation combined with pericardial devascularization through left thoracic cavity with esophageal incision from Oc-tober 2002 to October 2011,after splenectomy with periesophagogastric devascularization due to portal vein hypertension,were in-vestigated retrospectively and followed up for 1 to 9 years. Results Forty-three re-hemorrhage patients operated included 27 cas-es of selective operation and 16 cases of emergency operation. The mean follow-up time was 6.8 years. The hemostasis rate was 100%. 0ne died after the operation because of engaging in heavy labor,two had melena and were completely relived with the con-servative treatment,and all the rest had a good recovery. Conclusion The operation of varicose ligation combined with pericardi-al devascularization through left thoracic cavity with esophageal incision in the treatment of postoperative re-hemorrhage after sple-nectomy with periesophagogastric devascularization for advanced schistosomiasis has a satisfied efficacy.