CAJ | 학술논문

[目的]探讨预防性断流术治疗肝硬化门静脉高压症的临床疗效.[方法]102例肝功能良好的肝硬化门静脉高压症患者,合并食管胃底静脉重度曲张,行预防性断流术65例,药物治疗37例,比较两种方法的临床疗效.[结果]预防性断流组患者无一例死亡,术后腹腔内出血 2例 ,左膈下包裹性积液1例,均行保守治疗后治愈,术后无肝功能衰竭及肝性脑病发生,脾功能亢进消失,随访18个月无上消化道出血病例;药物治疗组随访18个月出现上消化道大出血12例 ,其中并发肝性脑病 2例 ,死亡 2例 ,脾功能亢进无改善.与药物组相比,手术组食管胃底曲张静脉消失率显著增高,上消化道出血率明显降低,其差异均有统计学意义( P <0.01).[结论]对于肝硬化门静脉高压症患者,合理把握手术指征,行预防性断流术,疗效满意,值得临床推广应用.
[목적]탐토예방성단류술치료간경화문정맥고압증적림상료효.[방법]102례간공능량호적간경화문정맥고압증환자,합병식관위저정맥중도곡장,행예방성단류술65례,약물치료37례,비교량충방법적림상료효.[결과]예방성단류조환자무일례사망,술후복강내출혈 2례 ,좌격하포과성적액1례,균행보수치료후치유,술후무간공능쇠갈급간성뇌병발생,비공능항진소실,수방18개월무상소화도출혈병례;약물치료조수방18개월출현상소화도대출혈12례 ,기중병발간성뇌병 2례 ,사망 2례 ,비공능항진무개선.여약물조상비,수술조식관위저곡장정맥소실솔현저증고,상소화도출혈솔명현강저,기차이균유통계학의의( P <0.01).[결론]대우간경화문정맥고압증환자,합리파악수술지정,행예방성단류술,료효만의,치득림상추엄응용.
Objective] To explore the clinical efficacy of prophylactic devascularization on patients with cirrhosis portal hypertension .[Methods] Among 102 cases of cirrhosis portal hypertension with good liver function and severe gastroesophageal varices ,65 patients underwent prophylactic devascularization and 37 pa‐tients received drug therapy .The clinical efficacy was compared between two methods .[Results] No one in prophylactic devascularization group died .Intraperitoneal hemorrhage after operation occurred in 2 patients . Left subphrenic encapsulated effusion was found in one patient .The 3 patients were cured by conservative treatment .No liver function failure and hepatic encephalopathy occurred .Hypersplenism disappeared after op‐eration .No upper gastrointestinal bleeding was found during 18 months of follow up .In drug therapy group , 12 patients had upper gastrointestinal bleeding including 2 patients complicated with hepatic encephalopathy and 2 dead patients during 18 months of follow up .The patients in drug therapy group had no improvement of hypersplenism .Compared with drug group ,the disappearance rate of gastroesophageal varices in prophylactic devascularization group was 96 .92% ,and the incidence of upper gastrointestinal bleeding decreased obviously , and there was significant difference between 2 groups( P < 0 .05) .[Conclusion] Reasonably mastering the op‐eration indications before prophylactic devasculariztion for patients with cirrhosis portal hypertension can ob‐tain satisfactory efficacy ,so it is worthy of clinical promotion .