门奇静脉断流改良术治疗门静脉高压症上消化道出血的效果评价

目的 探讨门奇静脉断流改良术治疗门静脉高压症上消化道出血的效果,为临床选择术式提供参考.方法 选取2006年6月～2012年6月140例门静脉高压症上消化道出血患者,按随机数字表法分为普通组和治疗组,各70例,普通组实施传统门奇静脉断流术治疗,治疗组实施门奇静脉断流改良术（即贲门周围血管离断加胃底环缝扎手术）治疗,术后对比两组的肝功能指标及手术指标.结果 两组治疗前后及治疗后的肝功能指标比较差异均无统计学意义（P＞0.05）.治疗组术后并发症发生率为10.00％,普通组为12.86％,差异无统计学意义（χ2=1.024,P=0.219）.治疗组住院时间为（12.93±4.04）d,普通组为（17.29±4.34）d,差异有统计学意义（t=5.394,P=0.016）.治疗组上消化道再出血发生率为1.43％,普通组为12.86％,差异有统计学意义（χ2=-1 3.445,P=0.001）.结论 门奇静脉断流改良术治疗门静脉高压症上消化道出血的临床效果显著,临床上可优先选用此术式.

Effect evaluation of improved gates azygos disconnection in the treatment of portal hypertension complicated with upper gastrointestinal hemorrhage

Objective To investigate effect of improved gates azygos disconnection in the treatment of portal hyperten- sion complicated with upper gastrointestinal hemorrhage in order to provide a reference for clinical surgery. Methods 140 patients with portal hypertension complicated with upper gastrointestinal hemorrhage from June 2006 to June 2012 were selected and divided into ordinary group and treatment group according to random digits table method,each group of 70 cases.Traditional portal azygos disconnection surgery was applied in ordinary group,improved portal azygos dis- connection surgery（pericardial devascularization plus gastric bottom ring suture operation）was implemented in treatment group.Liver function and other surgical indicators were compared between two groups. Results Liver function of two groups before treatment and after treatment was compared,liver function of two groups after treatment was compared, with no statistical difference （P〉0.05）.Incidence rate of postoperative complication in treatment group was 10.00%,inci- dence rate of postoperative complication in ordinary group was 12.86%,with no statistical difference（χ2=1.024,P=0.219）. Hospitalization time in treatment group was（12.93±4.04） d,hospitalization time in ordinary group was（17.29±4.34） d,with statistical difference（t=5.394,P=0.016）.Incidence rate of upper gastrointestinal rebleeding in treatment group was 1.43%, hospitalization time in ordinary group was 12.86%,with statistical difference（χ2=13.445,P=0.001）. Conclusion Improved gates azygos disconnection in the treatment of portal hypertension complicated with upper gastrointestinal hemorrhage has good clinical effecte,whieh can be a clinically preferred surgery.