摘要
目的：探索一种更有效防止门静脉高压症术后再出血方法的改良术式。方法：采用扩大贲门周围血管离断术（扩大术）治疗69例和贲门周围血管离断术（Hassab术）治疗53例（对照）。结果：Hassab术组术后近、远期出血率分别为9．4％和21．5％，明显高于扩大术组的0和5．6％（P＜0．05）；术后食管静脉曲张消失Hassab术组为18.2％，明显低于扩大术组的40．5％（P＜0．05），且术后食管静脉曲张无改变6例均为Hassab术组的患者；术后随访，扩大术组3年生存率比Hassab术组高。本组急症手术死亡率为17．1％明显高于择期手术死亡率的2．3％（P＜0．01）；肝功能按Child分级C级者手术死亡率为26.3％，明显高于A、B级的2.9％（P＜0.01）。扩大术组术后胃排空障碍发生率稍高，但差异无显著性。结论：扩大贲门周围血管离断术比Hassab术的近、远期疗效为优；急症断流术或（和）肝功能C级者手术效果欠佳。
Objective: In order to search a more effective management to lower the chance of esophageal varices rebleeding after surgery for portal hypertension. Method: Azygoportal disconnection by extended Hassab's procedure in 69 cases,and by Hassab's procedure in 53 cases as control. Results: After operation the short-term and long-term rebleeding rates were obviously higher (P<0. 05)in Hassab's group with 9. 4 % and 21. 5% than those in extended Hassab's group with 0% and 5. 6%, respectively. It was only the 6 patients who had undergone Hassab's procedure that showed no postoperative change in the esophageal varicosis. The rates of 3-year survival and of gastric emptving disorder were higher in extended Hassab's group than those in Hassab's group. The mortality(17. 1%) after emergency operation is much higher than that (2. 3%) after selective operation(P<0. 01). Patients with liver function graded Child C had a mortality of 26. 3% which is significantly higher(P<0. 01) than that (2. 9%) observed in those with liver function of Child A or B. Conclusion: The short and long-term results in extended Hassab's procedure are better than those in Hassab's operation. The benefit given by the emergency operation or by operation on those with liver function of Child C is not of much to patients.
出处
《广东医学院学报》
1997年第1期3-5,共3页
Journal of Guangdong Medical College
关键词
门脉高血压
食管静脉曲张
破裂
出血
外科手术
hypertension
portal vein
pericardial vessel
azygoportal disconnection
