129例门脉高压症手术治疗的体会

Surgical treatment of portal hypertension:analysis of 129 cases

分析１２９例门脉高压症手术治疗资料，其中７８例行断流术，５１例行分流术．断流术组肝功能ＣｈｉｌｄＡ、Ｂ级占６５．４％，分流术组ＣｈｉｌｄＡ、Ｂ级占９４．１％．断流术后近期再出血率１０．２％，肝性脑病２．６％，病死率５．１％；分流术后再出血率１１．７％．肝性脑病４％，病死率５．９％．本组资料分析表明：门脉高压症并发急性消化道大出血时宜先采用积极内科治疗，待出血停止，肝功能改善后行择期手术．断流术止血效果满意，操作简单，适用范围广泛，且有助于肝脏功能改善．似可作为门脉高压症并发出血的首选术式．

patients with portal hypertension were treated by operation.there were 78 patients who was carred out with devascularization. and 51 patients were performed by shunt. It was 64.5% as Child A &. B in the group of devascularization, 94.1 % as Child A &. B in the group of shunt. After devascularization, the recur rent bleeding rate was 10.2% encephalopathy 2. 6%, and the mortality rate was 5.1%. After shunt operation, the rebleeding rate was 11. 7% encephalopathy 4%, the mortality rate was 5. 9%. These results show that active nonoperation treatment is initial procedure for portal hypertension with bleeding esophageal varices. After hemistasis and liver function improveing,the operation can be performed. The effects of devascularization are satisfactory. Devascularization seems to be the first choice procedure for treatment of portal hypertension with bleeding esophageal varices. Devascularization is relative simple and safe and has wider indication, by the way, it can further improve liver function.