保留迷走神经主干的贲门周围血管离断术治疗门静脉高压症临床体会

目的 :探讨保留迷走神经主干的贲门周围血管离断术 (VTPPD)比较于切断迷走神经主干的贲门周围血管离断术加幽门成形术 (PD+PP)治疗门脉高压症的治疗效果。方法 :回顾性分析 1999— 10～ 2 0 0 3— 0 5实施的 VTPPD31例与 PD+PP4 8例 ,比较两组病人手术并发症 ,死亡率。结果 :VTPPD组手术死亡率为 9.7% ,PD+PP组手术死亡率为 12 .5 % ,两者死亡率无明显差异 (P >0 .0 5 ) ;VTPPD组并发症明显低于 PD+PP组 (P <0 .0 1)。结论 :保留迷走神经主干的贲门周围血管离断术能够降低术后并发症 ,提高门脉高压症手术的远期疗效。

VTPPD in the treatment of portal hypertension:Clinical experience

Objective: To investigate the therapeutic effect of VTPPD in treatment of portal hypertension by comparing with PD+PP. Methods: The clinical data of 31 patients and 48 patients with portal hypertension respectively receiving VTPPD and PD+PP in our hospital from October, 1999 to May, 2003 were retrospectively analyzed.Postoperative complications and mortality were compared between the two groups. Results: There was no significant difference between the mortality of VTPPD group (9.7%) and mortality of PD+PP group (12.5%) (P>0.05),but the complications of VTPPD group were significantly reduced compared with PD+PP group (P<0.01). Conclusions: VTPPD can decrease postoperative complications ,and improve long-term outcome of portal hypertention operation.