中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2014年
11期
828-830
,共3页
王智勇%张俊晶%乔建梁%孟兴凯
王智勇%張俊晶%喬建樑%孟興凱
왕지용%장준정%교건량%맹흥개
高血压,门静脉%吻合术,外科%食管和胃静脉曲张%贲门周围血管离断术
高血壓,門靜脈%吻閤術,外科%食管和胃靜脈麯張%賁門週圍血管離斷術
고혈압,문정맥%문합술,외과%식관화위정맥곡장%분문주위혈관리단술
Hypretension,portal%Anastomosis,surgical%Esophageal and gastric varices%Devascularization
目的 评价食管胃底吻合联合贲门周围血管离断术治疗门静脉高压症的疗效.方法 回顾性分析内蒙古大学附属医院2009年2月至2013年8月接受手术治疗门静脉高压症患者的临床资料,其中行食管胃底吻合联合贲门周围血管离断术组(研究组)30例,单纯贲门周围血管离断术组(对照组)56例,所有患者均常规切除脾脏. 结果 两组患者均无手术死亡.两组术后血清胆红素、白蛋白、血小板比较差异均无统计学意义(t=1.13、0.23、1.53,均P＞0.05).研究组和对照组肝性脑病发生率分别为3％、11％,3年死亡率分别为14％、24％,两组相比差异均无统计学意义(x2=0.61、1.22,均P＞0.05).研究组和对照组静脉曲张再出血率分别为10％、31％,差异有统计学意义(x2=4.61,P＜0.05).研究组食管胃底静脉曲张改善情况明显优于对照组,差异有统计学意义(P＜0.05).结论 食管胃底吻合联合贲门周围血管离断术在减少食管胃底曲张静脉残留及预防再出血方面优于单纯贲门周围血管离断术.
目的 評價食管胃底吻閤聯閤賁門週圍血管離斷術治療門靜脈高壓癥的療效.方法 迴顧性分析內矇古大學附屬醫院2009年2月至2013年8月接受手術治療門靜脈高壓癥患者的臨床資料,其中行食管胃底吻閤聯閤賁門週圍血管離斷術組(研究組)30例,單純賁門週圍血管離斷術組(對照組)56例,所有患者均常規切除脾髒. 結果 兩組患者均無手術死亡.兩組術後血清膽紅素、白蛋白、血小闆比較差異均無統計學意義(t=1.13、0.23、1.53,均P＞0.05).研究組和對照組肝性腦病髮生率分彆為3％、11％,3年死亡率分彆為14％、24％,兩組相比差異均無統計學意義(x2=0.61、1.22,均P＞0.05).研究組和對照組靜脈麯張再齣血率分彆為10％、31％,差異有統計學意義(x2=4.61,P＜0.05).研究組食管胃底靜脈麯張改善情況明顯優于對照組,差異有統計學意義(P＜0.05).結論 食管胃底吻閤聯閤賁門週圍血管離斷術在減少食管胃底麯張靜脈殘留及預防再齣血方麵優于單純賁門週圍血管離斷術.
목적 평개식관위저문합연합분문주위혈관리단술치료문정맥고압증적료효.방법 회고성분석내몽고대학부속의원2009년2월지2013년8월접수수술치료문정맥고압증환자적림상자료,기중행식관위저문합연합분문주위혈관리단술조(연구조)30례,단순분문주위혈관리단술조(대조조)56례,소유환자균상규절제비장. 결과 량조환자균무수술사망.량조술후혈청담홍소、백단백、혈소판비교차이균무통계학의의(t=1.13、0.23、1.53,균P＞0.05).연구조화대조조간성뇌병발생솔분별위3％、11％,3년사망솔분별위14％、24％,량조상비차이균무통계학의의(x2=0.61、1.22,균P＞0.05).연구조화대조조정맥곡장재출혈솔분별위10％、31％,차이유통계학의의(x2=4.61,P＜0.05).연구조식관위저정맥곡장개선정황명현우우대조조,차이유통계학의의(P＜0.05).결론 식관위저문합연합분문주위혈관리단술재감소식관위저곡장정맥잔류급예방재출혈방면우우단순분문주위혈관리단술.
Objective To evaluate the effect of esophagofundostomy combined with devascularization for the treatment of portal hypertension.Methods From February 2009 to August 2013,30 cases (research group) underwent esophagofundostomy combined with devascularization,while 56 cases (control group) were treated by devascularization only.Splenectomy was performed in all patients.Results There was no perioperative mortality in either group.The difference of postoperative serum bilirubin,albumin and blood platelet was not statistically significant (t =1.13、0.23、1.53,all P ＞ 0.05) ; The incidence of hepatic encephalopathy in research group and control group was 3％ and 11％,respectively,three years mortality was 14％ and 24％,respectively (x2 =0.61、1.22,all P ＞0.05).The rebleeding rate in research group was lower than control group,there was a significant difference (x2 =4.61,P ＜ 0.05).Research group was superior to control group in improving esophageal-gastric varices and there was a significant difference (P ＜ 0.05).Conclusions Compared with devascularization,esophagofundostomy combined with devascularization is more effective in reducing esophageal-gastric varices and prevention of rebleeding.
