选择性断流术和联合断流术治疗门静脉高压症的疗效分析

目的:探讨选择性断流术和联合断流术治疗门静脉高压症的临床疗效.方法:将2009年6月-2011年12月收治的门静脉高压患者247例,按手术方法分为选择性断流术组(126例)和联合断流术组(121例).分别对两组治疗前后的临床资料及疗效进行比较分析.结果:术后两组患者自由门静脉压力( FPP)较治疗前明显下降(均P＜0.05),且选择断流术组下降程度大于联合断流术组(P＜0.05).除肝功能Child-pugh评分外,选择断流术组术后再出血发生率,肝性脑病,门静脉系统血栓和门静脉高压性胃病的发生率以及胃底食道下段曲张静脉情况等指标均优于联合断流术组,差异均有统计学意义(均P＜0.05).结论:选择性断流术治疗门静脉高压症效果显著,并发症少,是一种理想的手术方法.

Efficacy comparison between selective devascularization and combined devascularization operation for portal hypertension

Objective:To investigate the clinical effect of selective devascularization and combined devascularization operation for portal hypertension. Methods:Two-hundred and forty-seven patients with portal hypertension admitted to our hospital from June 2009 to December 201 were designated into two groups according to their operative procedures,namely,the selective devascularization group(126 cases) and combined devascularization group(121 cases).The clinical data of the patients before and after surgery,and the clinical efficacies between the two groups were compared and analyzed. Results:The free portal pressures(FPP) of the patients in both groups were decreased significantly after surgery(both P<0.05),and the FPP in selective devascularization group decreased more significantly than that of the combined devascularization group(P<0.05).Except for the Child-Pugh score,the other indexes that included the incidence of postoperative recurrent hemorrhage,hepatic encephalopathy,portal venous thrombosis and portal hypertensive gastorpathy as well as degree of gastroesophageal varices of the selective devascularization group were all better than those of the combined devascularization group(all P<0.05). Conclusion:Selective devascularization is an ideal surgical procedure for portal hypertension because it is of favourable efficacy with fewer complications.