CAJ | 학술논문

目的探讨贲门周围血管缝扎术治疗肝硬化门静脉高压的临床疗效.方法回顾性分析2006年7月至2010年9月收治的门静脉高压症185例患者的临床资料,其中68例行贲门周围血管断流术,117例行贲门周围血管缝扎术.通过对两种治疗方式的临床疗效的观察,术中自由门静脉压(FPP)的动态监测,对术中、术后各临床观察指标,术后远期并发症及生存率行对比研究.结果术后两组FPP均下降,缝扎术组与断流术组比较差异有统计学意义(P＜0.01),FPP下降幅度:缝扎术组＞断流术组.对照两种手术方式术中及术后各临床指标,两组间各指标比较差异均有统计学意义(P均＜0.01).缝扎术组及断流术组均无手术死亡病例,断流术组再出血率高于缝扎术组,断流术组与缝扎组肝性脑病发生率相近,断流术组3年生存率低于缝扎术组.结论贲门周围血管缝扎术能降低患者FPP,同时能够有效减少食管及胃底部曲张静脉破裂再出血率,降低术后并发症发生率及病死率.
목적 탐토분문주위혈관봉찰술치료간경화문정맥고압적림상료효.방법 회고성분석2006년7월지2010년9월수치적문정맥고압증185례환자적림상자료,기중68례행분문주위혈관단류술,117례행분문주위혈관봉찰술.통과대량충치료방식적림상료효적관찰,술중자유문정맥압(FPP)적동태감측,대술중、술후각림상관찰지표,술후원기병발증급생존솔행대비연구.결과 술후량조FPP균하강,봉찰술조여단류술조비교차이유통계학의의(P＜0.01),FPP하강폭도:봉찰술조＞단류술조.대조량충수술방식술중급술후각림상지표,량조간각지표비교차이균유통계학의의(P균＜0.01).봉찰술조급단류술조균무수술사망병례,단류술조재출혈솔고우봉찰술조,단류술조여봉찰조간성뇌병발생솔상근,단류술조3년생존솔저우봉찰술조.결론 분문주위혈관봉찰술능강저환자FPP,동시능구유효감소식관급위저부곡장정맥파렬재출혈솔,강저술후병발증발생솔급병사솔.
Objective To investigate the clinical effect of cardiac peripheral vascular suture ligation on patients with portal hypertension.Methods From July 2006 to September 2010,the clinical data of 185 patients with portal hypertension were retrospectively analyzed.Sixty-eight patients were given gastroesophageal devasculariztion,117 patients were given gastroesophageal vessel suture ligation.By observation of the clinical efficacy of the two kinds of treatment and dynamic mornitor of the free portal pressure during operation,the clinical observation indexes and postoperative long-term complications and survival rate were compared.Results The FPP in the two postoperation groups all decreased,there was significant difference between suture group and devascularization group(P ＜ 0.01).FPP decline range:suture group ＞ devascularization group.There were significant differences in the clinical parameters during and after the operations(P ＜0.01).There was no operation death case in suture group or devascularization group.The rebleeding rate in devascularization group was higher than that in the suture group,the incidences of hepatic encephalopathy in the two groups were basically the same; the 3 years survival rate in the devascularization group was lower than that in the suture group.Conclusions Cardiac peripheral vascular suture can reduce the FPP,effectively reduce the rebleeding rate of the esophageal and gastric fundus varicose vein,and reduce the incidence of postoperative complications and mortality rate.