改良Sugiura手术治疗门静脉高压症38例分析

Analysis of modified sugiura operation for treating 38 cases of portal hypertension

目的 :评价改良Sugiura手术治疗门静脉高压症的疗效。方法 :回顾性分析对38例肝炎后肝硬化性门静脉高压症患者实行改良Sugiura手术治疗的情况。结果 :无手术死亡及肝性脑病发生 ,再出血率为2 63% (1/38) ,胃排空障碍1例 (2 63% ) ,脾静脉血栓形成2例 (5 26% ) ,无食管吻合瘘发生。手术后1～3月 ,27例术前肝功能ChildB级者 ,有18例转为A级 ;术后半年全组病例均接受胃镜检查 ,食管胃底曲张静脉消失者28例 ,显著改善者10例。结论 :本手术治疗肝炎后肝硬化性门静脉高压症的疗效令人满意 ,再出血率低 ,并发症少 ,其操作并不复杂 ,是一种值得推广的治疗门静脉高压症的方法。

Objective:To evaluate the curative effect of modified sugiura operation for treating portal hypertension.Methods:38 patients with portal hypertension of liver cirrhosis after hepatitis performed with modified sugiura operation were analysed retrospectively.Results:No operative case died and no hepatic encephalopathy was not found,and so was not anastomotic fistula of esophagus.The rebleeding rate was 2.63%(1/38),the evacuation disturbance of stomach was found in 1 case(2.63%),thrombosis of splenic vein in 2 cases(5.26%).In 1-3 months after operation,the liver function in 27 cases before operation was grade B(child grading),in which 18 cases converted to grade A.All the patients received gastroscopy in 6 months after operation,phlebeurysma of esophagus and fundus ventriculi disappearred in 28 cases,significant improvement in 10 cases.Conclusion:The curative effect of modified sugiura operation for treating portal hypertension of cirrhosis after hepatitis is satisfactory,with less rebleeding rate,less complications and easy operation,which is worth spreeding in clinical application.