门奇静脉断流术与改良Sugiura术治疗门静脉高压症的比较

Comparision of portal-azygous disconnection and modified Sugiura operation in the treatment of portal hypertension

目的探讨单纯门奇静脉断流术与改良Sugiura术在门静脉高压症治疗中的疗效。方法回顾性分析近1 3年行改良Sugiura手术3 0例患者与同期行单纯门奇静脉断流术治疗门静脉高压症3 4例的临床资料。结果两组患者术前的一般临床资料具有可比性(均P>0.0 5),两组均无术中、术后近期严重并发症和手术死亡病例。两组在手术中出血、术后近期并发症、住院天数、术后远期消化道大出血率差异无显著意义(P>0.0 5);但改良组食管静脉曲张消失者明显多于断流组(P<0.05)。结论改良Sugiura手术后的食管静脉消失率明显好于传统断流术,但两者的远期疗效相似。

Objective To discuss the therapeutic effect of simple portal-azygous disconnection and modified Sugiura operation （ MSO ） in the treatment of portal hypertension. Methods The operative safety, postoperative recovery, complications and follow-up results were compared between 30 cases of simple （simple group ） and 34 cases of MSO. Results The basic clinical informations were comparable between the two groups（ P 〉 0.05 ）. No intra-or post-operative severe complications nor mortality occurred in either group. There was no significant difference between the two groups in operative blood loss, postoperative recovery time and hospital stay days （ all P 〉 0. 05 ） . The number of cases with disappearance of esophagcal varices was significantly higher in MSO group than in the simple venous disconnection group （ P 〈 0. 05 ） . Conclusions The obliteration rate of esophageal varices is significantly better after the modified Sugiura operation than after the traditional disconnection operation. However, the long-term therapeutic effects are similar.