胆道多次手术合并肝硬化患者门静脉高压症的评估及处理

目的研究多次手术合并肝硬化患者门静脉高压症的评估及处理。方法对我院2009年5月-2011年5月期间收治的21例多次手术合并肝硬化患者门静脉高压症患者相应的临床资料进行回顾性分析。结果术前21例患者均有肝硬化,门静脉高压表现,其中3例食道静脉曲张,21例患者,胆汁性肝硬化者13例,血吸虫肝硬化5例,肝炎肝硬化3例,手术方法 ：单纯胆道手术19例,胆肠吻合术合并胆总管切开取石术T管引流术2例,术中出血量约800-1600ml。术后2例胆漏,1例肠瘘,2例上消化道出血,2例死于肝功能失代偿,脏器衰竭。Child-Pugh分级,A级5例,B级9例,C级7例。结论针对胆道多次手术合并肝硬化门脉高压的患者,手术风险较大,在注意结合术前风险评估的同时制定合理的治疗措施变可以取得较满意的手术效果。另外使用Child-pugh对于再次胆道合并肝硬化门脉高压患者并不适用。

Biliary cirrhosis portal vein several operations with ocular evaluation and treatment

Objective Study the effect of Biliary cirrhosis portal vein several operations with ocular evaluation and treatment.Methods 21 cases with several surgery with liver cirrhosis portal hypertension were selected as the research object from May 2009 to May 2011 in our hospital,with which the corresponding to the clinical data were retrospectively analyzed.Results Preoperative 21 patients are cirrhosis,the portal hypertension performance,including 3 cases of esophageal varices,21 patients,biliary cirrhosis in 13 patients,schistosomiasis liver cirrhosis in 5 cases,3 cases of hepatitis b liver cirrhosis;Surgical method: pure biliary surgery(19 cases),bravery bowel anastomosis with bravery manager stone was cut take t-tube drainage in 2 cases,peri-operative bleeding about 800-1600ml.After surgery,two cases of bile leakage,and 1 case of intestinal fistula,2 cases of upper gastrointestinal bleeding,2 cases died of liver decompensation,viscera failure.Child-Pugh classification,A level in 5 patients,and class B 9 cases,C level 7 cases.Conclustion Biliary cirrhosis several operations with portal hypertension patients,surgical risk bigger,pay attention to the union in preoperative risk assessment and set up reasonable treatment measures change can be satisfied with the operation effect.In addition,use of Child-pugh biliary cirrhosis again for merger portal hypertension patients do not applied.