贲门周围血管离断术后再出血的治疗

目的积累减少贲门周围血管离断术后再出血治疗的有益经验。方法回顾分析十年间贲门周围血管离断治疗门静脉高压症的病例。结果７８例门静脉高压症手术后发生再出血２１例（发生率为２６．９２％），经非手术治愈１９例。随着对门静脉高压症患者胃底贲门周围血管离断手术操作的彻底性和完全性认识的不断提高，以及对贲门区组织学研究的逐渐深入，术后再出血发生率逐渐下降。结论在贲门周围血管离断术后再出血的治疗中最关键的是对再出血的定位。再出血发生后非手术治疗的目的主要是减少门脉血流量和减低肝脏及侧支循环的阻力。

Treatment of Recurrent Bleeding after Pericardial Devascularization

Objective To accumulate the clinical experience of reducing recurrent bleeding after pericardial devascularization.Method 78 pericardial devascularised patients during the last ten years were studied retrospectively.Results 21 patients occured rebleeding among all cases and the recurrent bleeding rate was 26.92%.There were 19 cases cured by non surgery.Using retrospective analysis,the recurrent bleeding rate after pericardial devascularization was gradually declined,which was associated with the gradually increasing of the realizing to the thoroughness and the completeness of devascularization and the gradually deepening of the histological study of the cardia region.Conclusions The key to the treatment of recurrent bleeding was the localization of the bleeding focus.The main aim of non surgery was to decrease portal blood flow and resistance of hepatic and collateral circulation.