选择性改良Sugiura手术治疗门静脉高压症出血24例分析

目的探讨经腹选择性改良Sugiura手术在治疗门静脉高压症伴出血中的应用价值。方法回顾2006年1月～2011年6月本院收治门静脉高压症患者24例，行选择性改良Sugiura手术的临床资料，其中急诊手术14例，相对择期止血后1～2周内手术10例。术中借助胃底大弯侧切口直视下结扎贲门周围曲张血管或剔除曲张静脉团，有利于防止术后再出血和胃黏膜病变。结果全组围术期无死亡病例、无再出血及肝性脑病发生。均获随访，随访时间6个月～6年，平均4年。于手术6个月后均行胃镜检查或食管钡餐检查提示食管胃底静脉曲张消失率90％，改善率10％。结论选择性改良Sugiura手术治疗门静脉高压症伴出血疗效令人满意，近远期止血效果确切、并发症少，是I临床值得应用和推广的术式。

Selective modified sugiura operation in the treatment of 24 patients with bleeding portal hypertension

Objective To investigate the value of modified sugiura procedure in the treat- ment of portal hypertension with variceal bleeding. Methods Retrospective analysis of 24 patients with portal hypertension during January 2006 to June 2011 was conducted. All the patients were performed with modified sugiura procedure which included 14 patients with emergency surgery and 10 with elective surgery. Results The whole group had no perioperative deaths, further bleeding and hepatic encephalopathy. Disappearance of esophageal varices was 90 %, and improvement rate was 10 %. Conclusion The outcome of modified sugiura surgical in the treatment of portal hyper- tension with varieeal bleeding is satisfactory. It is worthy of clinical application.