门静脉高压症child分级C级患者13例急诊手术治疗体会

目的:探讨门静脉高压症child分级C级患者急诊手术治疗的疗效及可行性、合理性。方法:回顾性分析1999年10月~2006年12月急诊手术治疗门静脉高压症child分级C级患者13例的治疗情况。结果:手术13例,术中死亡1例,术后30 d内死亡3例,死亡率为31%;近期再出血率为0;肝性脑病发生率为0;9例痊愈出院。随访9例,1例术后2年余死于肺部疾病,1例术后5年余再出血经保守治疗无效死亡,再出血率为7%。肝性脑病发生率为0。结论:门静脉高压症child分级C级患者急诊手术治疗的疗效是确切的、可行的,相对合理的,尤其是在基层医院其他治疗手段不多,保守治疗无效,有选择性的积极争取早期手术是合理的,可推广的。

Emegency surgery for portal hypertension in Child classification C: a report of 13 cases

Objective: To investigate the effect,feasibility and rationality of emegency surgery for patients with portal hypertension in Child classification C.Methods: Data of 13 patients with portal hypertension in Child classification C underwent surgical operation from 1999~December 2006 were studied retrospectively.Results: Of the 13 patients treated with surgical operation,one case died during the operation.3 cases died in 30 days after operation,the fatality rate was 31%;no patient relapsed bleeding short time after the operation;no patient occurred hepatic encephalopathy.Conclusion: Emegency surgery for patients with portal hypertension in Child classification C is effective,feasible and relative resonable;especialy in local general hospital where is short of advanced medical approach,a early selective surgery for the patients who failed to the conservative therapy may be a resonable choice,deserve generalization.