脾切除加贲门周围血管离断术治疗门静脉高压症61例报告

Report of Splenectomy Plus Pericardial Devascularization in Treatment of 61 Cases of Portal Hyportension

目的:探讨脾切除加贲门周围血管离断术治疗门静脉高压症的效果.方法:回顾61例采用脾切除加贲门周围血管离断术治疗门静脉高压症的临床资料,对手术前后的肝功能、脾亢症状、食管胃底曲张静脉及术后并发症等进行分析.结果:全组无手术死亡,无脑病发生.术后半个月肝功能好转53例,无变化8例.全组病例脾亢症状消失.术后2个月胃镜复查,食管胃底静脉曲张消失或明显好转47例,好转14例.术后随访48例12～24个月,再出血率8.3%(4/48).结论:脾切除加贲门周围血管离断术治疗门静脉高压症不仅急症手术止血率高,脑病发生率低,而且操作简便,手术条件较宽,易在基层医院开展,有良好的临床实用价值.

Objective:To study clinical effect of splenectomy plus pericardial devascularization in portal hypertension.Methods:The clinical data of 61 cases of portal hypertension treated with splenectomy plus pericardial devascularization was retrospectively reviewed.The functional spleen, cirsoid oesothagus and syrcdrome of pre-and postoperation were observed and analysed.Results:There was no death,no encephalopathy,and the effect was satisfactory.There were 53 cases of liver function look up better half month after operation.All cases of the group clear away the symptom of excessive spleen,countercheck stomach by gastroscopy after 2 months of operation.There were 47 cases of cirsoid oesophagus and bottom stomach cleared away or look up better extremely.There were 14 cases looking up better.Among 48 cases followed up for 12~24 months,the rebleeding rate was 8.3%(4/48).Conclusion:Spenectomy plus pericardial devascularization in treatment portal hypertension, not only the astrictive rate of emergency operation washigh and encephalopathy rate was low,but also it had simple operation, ample qualification.