肠腔静脉人工血管C型分流术的远期疗效观察

Long-term therapeutic effect of the mesocaval C shunt with artifical blood vessel

目的探讨肠腔静脉C型分流术治疗食管胃底静脉曲张破裂出血的远期疗效。方法对咸阳市中心医院肝胆外科1992年以来施行的36例肠腔静脉C型分流术的临床资料进行总结分析。结果36例患者术后门静脉压平均下降1.51kPa,胃镜检查食管静脉曲张均有明显减轻或消失。术后再出血率5.6%,肝性脑病发生率8.3%,术后1年、3年、5年及10年的生存率分别为97.2%、93.3%、89.3%及66.7%。结论肠腔静脉C型分流术手术适应证广,操作简单,近、远期疗效满意,适于推广。

Objective To evaluate the long-term effectiveness of the mesocaval C shunt in the treatment of gastroesophageal varicosis rupture bleeding. Methods Clinical data of 36 cases with gastroesophageal varicosis bleeding performed mesocaval C shunt since 1992 were analyzed. Results Postoperative portal vein pressure in 36 cases were reduced by an average of 1.51 kPa （15.38 cmH2O）. The gastroesophageal varicosis was alleviated in all patients in postoperative fibergastroscopic examination. The rebleeding rate and postoperative hepatic eneephalopathy occurrence rate were 5.6 % and 8.3 % respectively. The postoperative surrival rate in 1, 3, 5, 10 years were 97.2 %, 93,3 %, 89.3 %, 66.7 %. Conclusion There is wide indication of mesocaval C shunt technique and it is easy to operate, satisfactory for short-term and long-term therapeutic effectness. Thus this technique is suitable for spreading its application.