腹部外科
腹部外科
복부외과
JOURNAL OF ABDOMINAL SURGERY
2014年
2期
105-107
,共3页
张磊%于鑫%章锐%刘飞龙%张万广
張磊%于鑫%章銳%劉飛龍%張萬廣
장뢰%우흠%장예%류비룡%장만엄
高血压,门静脉%食管和胃静脉曲张%手术后并发症
高血壓,門靜脈%食管和胃靜脈麯張%手術後併髮癥
고혈압,문정맥%식관화위정맥곡장%수술후병발증
Hypertension,portal%Esophagogeal and gastric varices%Postoperative complications
目的:探讨联合断流术治疗门静脉高压症并食管胃底静脉曲张的效果。方法对2005年1月至2013年6月间采用择期联合断流术的51例肝硬化门静脉高压症临床资料进行回顾性分析。结果所有患者均无手术死亡。平均手术时间为(3.6±0.8)h,输血量为(547±120)ml,术后平均住院天数为(10.3±3.2)d。胸腔积液6例(11.8%),腹水7例(13.7%),门静脉血栓12例(23.5%),均无吻合口瘘和吻合口狭窄。肝性脑病0例,再出血率3.9%(2/51)。术后6个月随访,食管胃底曲张静脉消失35例(68.6%),显著改善15例(29.4%),无明显变化者1例(2.0%)。结论联合断流术可以有效治疗食管胃底静脉曲张,并发症少,再出血率低,是一种值得推广的治疗门静脉高压症的手术方式。
目的:探討聯閤斷流術治療門靜脈高壓癥併食管胃底靜脈麯張的效果。方法對2005年1月至2013年6月間採用擇期聯閤斷流術的51例肝硬化門靜脈高壓癥臨床資料進行迴顧性分析。結果所有患者均無手術死亡。平均手術時間為(3.6±0.8)h,輸血量為(547±120)ml,術後平均住院天數為(10.3±3.2)d。胸腔積液6例(11.8%),腹水7例(13.7%),門靜脈血栓12例(23.5%),均無吻閤口瘺和吻閤口狹窄。肝性腦病0例,再齣血率3.9%(2/51)。術後6箇月隨訪,食管胃底麯張靜脈消失35例(68.6%),顯著改善15例(29.4%),無明顯變化者1例(2.0%)。結論聯閤斷流術可以有效治療食管胃底靜脈麯張,併髮癥少,再齣血率低,是一種值得推廣的治療門靜脈高壓癥的手術方式。
목적:탐토연합단류술치료문정맥고압증병식관위저정맥곡장적효과。방법대2005년1월지2013년6월간채용택기연합단류술적51례간경화문정맥고압증림상자료진행회고성분석。결과소유환자균무수술사망。평균수술시간위(3.6±0.8)h,수혈량위(547±120)ml,술후평균주원천수위(10.3±3.2)d。흉강적액6례(11.8%),복수7례(13.7%),문정맥혈전12례(23.5%),균무문합구루화문합구협착。간성뇌병0례,재출혈솔3.9%(2/51)。술후6개월수방,식관위저곡장정맥소실35례(68.6%),현저개선15례(29.4%),무명현변화자1례(2.0%)。결론연합단류술가이유효치료식관위저정맥곡장,병발증소,재출혈솔저,시일충치득추엄적치료문정맥고압증적수술방식。
Objective To explore the safety and efficacies of combined devascularization operation for esophagogastric varices in patients with portal hypertension due to liver cirrho-sis.Methods The clinical data of 5 1 cases with portal hypertension undergoing combined devasculariza-tion operation from January 2005 to June 2013 were analyzed.Results There was no occurrence of intr-aoperative mortality.The mean operative duration was 3.6 ±0.8 hours,transfusion volume 547 ± 120 ml and mean postoperative hospital stay 10.3±3.2 days.The major complications included pul-monary effusion (n =6, 1 1 .8%),transient ascites (n = 7, 13.7%)and asymptomatic portal vein thrombosis (n =12,23.5%).Rebleeding (n =2,3.9%)was documented during a follow-up peri-od of 6 months.Postoperative endoscopy revealed that varices improved significantly from severe to mild (29.4%)and even disappeared (68.6%).Conclusions With lower rates of complications and bleeding,combined devascularization operation is safe and efficacious for esophagogastric varices in pa-tients with portal hypertension due to liver cirrhosis.