环形缝扎加胃底折叠术预防晚期血吸虫病病人术后再出血效果

目的 目的 评估食管下段梯状环形缝扎黏膜下血管及胃底折叠术对晚期血吸虫病 （晚血） 门脉高压症并发上消化道 出血的治疗效果。 方法 方法 2006-2011年选择患晚血门脉高压症患者， 随机分为联合手术治疗组 （联合组） 与单纯手术治疗 组 （单纯组）。单纯组患者行门奇静脉断流术， 联合组在此基础上加行食管下段梯状环形缝扎黏膜下血管及胃底折叠术。 术后通过胃镜检查随访， 比较2种术式的治疗效果。结果 结果 共选择晚血患者158例， 联合治疗组75例， 单纯治疗组83例。 术后两组治疗有效率分别为81.3 % （61/75） 和30.1% （25/83）（χ2 =39.44， P < 0.01）， 发生再出血率分别为2.7 %（2/75） 和 12.0% （10/83）（χ2 =24.36， P < 0.01）， 两组差异有统计学意义。结论 结论 食管下段梯状环形缝扎黏膜下血管及胃底折叠术对 预防术后再出血效果明显， 且术式安全， 可作为治疗晚血门脉高压症的常规手术方式。

Effect of ladder ring suture of esophageal mucosa vascular combined with Nissen's fundoplication on prevention from rebleeding of patients with advanced schistosomiasis

Objective To evaluate the effectiveness of the ladder ring suture of the esophageal mucosa vascular combined with Nissen’ s fundoplication on provention from rebleeding of patients with advaced schistosomiasis Methods From August 2006 to August 2011，75 patients with advanced schistosomiasis portal hypertension received the portal azygous disconnection and ladder ring suture of the esophageal mucosa vascular combined with Nissen’ s fundoplication（a combined group），and 83 patients with advanced schistosomiasis portal hypertension received the portal azygous disconnection only（a simple group），and the re? sults of the follow?up were analyzed. Results The effective rates were 81.3%（61/75）in the combined group and 30.1%（25/83） in the simple grouup，and the rebleeding rates were 2.7%（2/75）and 12.0%（10/83）in the two groups，respectively（P < 0.01） . Conclusion The ladder ring suture of the esophageal mucosa vascular combined with Nissen’ s fundoplication is effective and safe on the prevention from rebleeding of patients with advaced schistosomiasis.