门静脉高压症预防性手术方法探讨

Evaluation of the preventive operation for portal hypertension

目的探讨联合手术在门静脉高压症病人预防性手术中的地位。方法回顾性分析1997年3月至2004年3月84例肝炎后肝硬化门静脉高压症病人的治疗效果。结果联合术后自由门静脉压力下降(12.21±4.73)cmH2O(1cmH2O=0.098kPa),明显优于断流术后下降(7.16±8.35)cmH2O;断流术后门静脉血流量增加,而联合术后门静脉血流量减少,食管静脉曲张明显减轻;联合术后病人出血率和病死率均为6.25%,明显优于断流术组和未手术组(P<0.05)。结论对肝功能尚好的门静脉高压症病人实施预防性联合手术有助于提高其生活质量。

Objective To evaluate the situation of combined operation in preventive operation for portal hypertension （PHT）. Methods The therapeutic results of 84 PHT patients for posthepatitie cirrhosis in the First Afiliated Hospital of Guangxi Medical University from March 1997 to March 2004 were analyzed. Results The free portal pressure （FPP） decreased（ 12. 21：1： 4. 73 ） cmH20 （ 1cmH2O =- 0. 098 kPa） after combined operation, which decreased （ 7. 16：1： 8. 35 ） cmH2O after devaseularization for portal hypertension （PHT）. Portal venous flow （PVF） slightly increased after devaseularization, but decreased after combined operation （ P 〈 0. 05 ）. Compared with devascularization,esophageal varices distinctly relieved after combined operation （ P 〈0. 05）. Both the bleeding rate and the mortality rate were 6. 25% for the group who receipted combined operation, which were better than the group of devaseularization or the group of nonoperation （ P 〈 0. 05）. Conclusion Combined operation for the PHT patients with good liver function is attributed to the improvement of the life quality.