纤维蛋白封闭剂在晚期血吸虫病门静脉高压症手术治疗中的应用价值

目的探讨纤维蛋白封闭剂（FS）在晚期血吸虫病性门静脉高压症手术治疗中的应用价值。方法将2年内收治的92例血吸虫病性门静脉高压症患者接受相同手术方式后分成2组：断流术加纤维蛋白封闭剂组（FS组，64例）；单纯性断流术未用FS组（NSF组，28例）。比较两组手术后4周内发热、脾窝渗液和手术4周后上消化道再出血、胃黏膜损伤及肝性脑病等并发症的发生情况。结果FS组手术近期脾窝渗液和发热率明显低于NFS组（P〈0．05）；FS组和NFS组随访期间上消化道再出血率分别为1．6％和14．3％（P〈0．05），门静脉高压性胃黏膜损伤发生率分别为297％和64．3％（P〈0．01）；但不增加肝性脑病发生率（P≥0．05）。结论FS可有效地降低手术后近期和远期并发症的发生，提高晚期血吸虫病性门静脉高压症患者的手术疗效。

Effect of fibrin sealant during operation for late-stage portal hypertension caused by schistosomiasis

Objective To study the application effect of fibrin sealant(FS) during operation for late-stage portal hypertension caused by schistosomiasis.Methods From Jun,2003 to Jun,2005,92 cases of(late-stage) portal hypertension caused by schistosomiasis treated by portal-systemic disconn-ection(PSD)(operation) were divided into two groups,namely PSD group and PSD+FS group.The early complications such as fever and exudate in splenic fossa,as well as long term complications such as recurrent bleeding,(hypertensive) gastropathy were compared in the 2 groups,and encephalopathy were compared between 64 cases of patients with FS and 28 cases of patients without FS.Results The patients undergoing PSD+FS showed decreased the exudate in splenic fossa and fever(P<0.05,respectively).Recurrent bleeding rate was(1.6)% in PSD+FS group and 14.3% in PSD group(P<0.05),and portal hypertensive gastropathy was 29.7% in PSD+FS group and 64.3% in PSD group(P<0.01),but the occurrence rate of hepatic encephalopathy was no different in the 2 groups(P>0 05).Conclusions FS application during operation is effective in attenuating early and long term operative complications of portal hypertension caused by(schistosomiasis),and improving outcome of surgical treatment.