胆囊结石合并门静脉高压症的处理

目的　探讨胆囊结石合并门静脉高压症的临床处理。方法　 46例患者 ,肝功能分级ChildA级 2 6例 ,ChildB级 12例 ,ChildC级 8例 ;急诊胆囊切除 6例 ,腹腔镜胆囊切除 10例 ,胆囊、脾切除和贲门周围血管离断术 10例 ,单纯胆囊切除 16例 ,单纯药物治疗 (包括消炎利胆、溶石和降低门静脉压力 ) 4例。结果　术后腹腔出血 2例 ,经用止血剂和输鲜血或血小板等保守治疗治愈 1例 ,开腹止血治愈 1例。术后肝性脑病 2例 ,经保肝、降血氨等治疗治愈。结论　积极保肝和对症支持治疗 ,依患者具体情况采用个体化治疗方案 ,能够降低治疗并发症 ,提高治愈率。

Clinical treatment about gallbladder calculus with portal hypertension

Objective To inquire into the clinical treatment about gallbladder calculus with portal hypertension.Methods 46 cases were selected in the group,liver function was Child A in 26 cases,Child B in12 cases,Child C in 8 cases. 6 cases were performed an emergency laparotomic cholecystectomy,10 cases by laparoscopic cholecystectomy in emergence,10 cases were performed an cholecystectomy and splenectomy with pericardiac devascularization,16 cases were performed a cholecystectomy,4 cases by simple drugs therapy.Results 2 cases were celiac haemorrhage,which were cured by medication and operation,2 case was hepatoencelphalopathy cured by medication.Conclusion It can reduce the complications of the clinical treatment and increase the clinical cure rate by improving the live function and supporting treatment according the disease,applying individual therapeutic projects according by special condition.