安全施行门奇断流术治疗107例门脉高压合并脾亢的初步体会

目的探讨安全施行门奇断流术合理的围术期管理方法以及术中的技术要点。方法回顾性分析我中心2010年7月至2011年6月收治的107例肝硬化门静脉高压患者围术期管理及其效果。结果术中失血量平均为(251.40±179.95)ml,其中肝功Child B级者失血量为(209.89±109.6)ml,Child C级者失血量为(487.50±294.68)ml,两组分布比较差异有统计学意义(P<0.05);平均输血量为(545.45±311.01)ml,其中Child B级组3例,输血率为3.30%,Child C级组8例,输血率为50%,两组输血率差异有统计学意义(P<0.05);术后6例发生肝性脑病;术后2例继发肝肾综合征。结论术前积极改善肝功能,术中有效控制出血,保护性利尿,以及术后早期营养支持等综合措施是提高手术成功率和降低并发症发生率的有效方法。

Initial experience of security implementation of extensive esophagogastric devascularization and splenectomy on 107 patients with portal hypertension and hypersplenism

Objective We seek to provide a better approach to manage of patient with advanced liver disease and portal hypertension undergoing esophagogastric devascularization and splenectomy surgery.Methods Retrospective analysis was conducted of records from July 2010 through Jun 2011 at our center.We were reviewed for effect of perioperative management,operation results,and complications.Results A total of 107 patients were identified with advanced liver cirrhosis,hypersplenism and portal hypertension,as well as th...