贲门周围血管离断术治疗门静脉高压症47例

目的总结贲门周围血管离断术治疗门静脉高压症在基层医院的应用体会。方法选择笔者所在医院2005年1月～2011年1月47例行贲门周围血管离断术治疗的门静脉高压症患者资料进行回顾性分析,所有患者均随访6～24个月,观察治疗效果及并发症。结果本组47例患者采用选择性断流术与非选择性断流术治疗后,肝动脉血流量明显增加,门静脉血流量明显下降,但选择断流术治疗的患者平均肝动脉血流量增加幅度明显大于非选择性断流术,门静脉血流量减少值明显大于非选择性断流术,两种断流术比较差异有统计学意义(P<0.05)。25例选择断流术共发生并发症4例,并发症发生率为16.0%,死亡3例,死亡率12%;非选择断流术的22例患者共发生并发症7例,并发症发生率为31.82%,死亡6例,死亡率27.27%,两种方法比较差异有统计学意义(P<0.05)。结论选择性贲门周围血管离断术是基层医院治疗门静脉高压症的有效方法,可明显减少并发症的发生和提高预后。

Treating 47 cases with hypertension of the portal vein by pericardial pericardial vascular amputation surgery

Objective To summarize the application experience of treating hypertension of the portal vein by pericardial pericardial vascular amputation surgery in the basic level hospital.Methods The clinical data of 47 patients with hypertension of the portal vein treated by pericardial pericardial vascular amputation surgery in our hospital from January 2005 to Januar 2011 were analyzed retrospectively.All the patients were followed up for 6 to 24 months,observing the treatment effects and complications.Results As for the 47 patients,after the treatment of selective devascularization and non selective devascularization,hepatic arterial blood flow increased significantly and portal vein blood flow decreased significantly.But the increased amplitude of mean hepatic artery blood flow of patients with the treatment of selective devascularization was greater evidently than the selective the treatment of devascularization.Reducing value of portal blood flow was greater significantly than non selective devascularization.The difference between the two kinds of disconnection was significant,which had statistical significance(P < 0.05).As for 25 patients with selective devascularization,there were 4 cases encountering complications and the complication rate was 16.0%.3 cases died and the mortality rate was 12%.As for 22 patients with the treatment of non selective devascularization,there were 7 patients with complications and the complication rate was 30.82%,6 cases died and the death rate was 27.27%.The difference between 2 kinds of method was evident,which had statistical significance(P < 0.05).Conclusion Selective pericardial devascularization is an effective method to treat gate static pulse hypertension in the basic level hospital,which can reduce the incidence of complications significantly and improve the prognosis.