生物蛋白胶联合大网膜包肾在门静脉高压症手术治疗中的应用

目的:评价医用生物蛋白胶(BFG)联合大网膜包肾(ORP)对门静脉高压症患者断流术后近期和远期疗效的影响。方法:将我院3年内(2003年11月～2006年5月)收治的118例门静脉高压症接受选择性贲门周围血管离断术(sPCDV)患者分成两组,即应用BFG联合ORP组(A组,n=72)和对照组(B组,n=46),比较两组手术后近期(一月)脾窝渗液、发热和远期上消化道再出血、肝性脑病和胃病等并发症的发生率。结果:A组手术近期脾窝渗液和发热率明显低于B组(P<0.05);A组和B组随访期间上消化道再出血率分别为1.3%和10.8%(P<0.05)、门静脉高压性胃病发生率分别为30.6%和65.2%(P<0.05);A组肝性脑病发生率与B组无明显差异(P>0.05)。结论:BFG联合ORP可有效降低选择性断流术后近期和远期并发症的发生,提高门静脉高压症患者断流术的疗效。

Biomedical Fibrin Glue Combined with Omentorenopexy and Its Effect on the Operation of Portal Hypertension

Objective:To evaluate the effect of biomedical fibrin glue(BFG)combined with omentorenopexy(ORP)on the operation of portal hypertension.Method:From Nov 2003 to May 2006,118 cases of portal hypertension with selective Periesophagogastric devascularization(sPCDV) were allocated to two groups:the BFG combined with ORP group(group A,n=72) and the control group(group B,n=46).The early complications such as febrile and exudate in splenic fossa,as well as long-term complications such as recurrent bleeding,hypertensive gastropathy,and encephalopathy were compared between group A and B.Results:The patients in group A showed decreased exudate in splenic fossa and febrile(P<0.05,respectively).Rate of recurrent bleeding(1.3% vs 10.8%,P<0.05) and portal hypertensive gastropathy(30.6% vs 65.2%,P<0.05) was reduced markedly in group A,while the risk of hepatic encephalopathy was not increased(P>0.05).Conclusion:BFG combined with ORP appears to be effective in attenuating early and long-term complications of sPCDV and improving the efficacy of it on portal hypertensive patients.