门静脉高压症反复上消化道出血的外科治疗

Treatment of upper digestive tract bleeding with portal hypertension

目的探讨经胸贲门周围血管离断术治疗的门静脉高压症引起的反复上消化道出血。方法回顾性分析我院肝炎后肝硬化门静脉高压症并上消化道反复出血患者136例,均经胸行贲门周围血管离断术。结果痊愈出院130例,急诊手术死亡4例,择期手术死亡2例。结论经胸贲门周围血管离断术治疗门静脉高压症引起的反复上消化道出血与其它手术方式相比,具有操作清晰,断流更加彻底、安全,急诊止血率高、死亡率低、并发症少、长期生存率高等优点,值得临床推广。

Objective To evaluate of transthoracic extensive devascularization around the cardia in the treatment of portal hypertension of posthepatitic cirrosis combined recurrent upper digestive tract bleeding. Methods 136 patients with portal hypertension of posthepatitic cirrosis combined recurrent upper digestive tract bleeding were treated with transthoracic extensive devascularization around the cardia. Result 130 patients were cured;Gpatients died （4 treated with emergency surgical procedure and 2 treated with selective surgical procedure）with the operative mortality 4. 4%. Conclusion Compared with other surgical proceduces, transthoracic extensive devascularization around the cardia has the virtue of more com- plete devascularization, safer, higher rate of emergency control of active bleeding, and higher long - term survival rate, less mortality rate and fewer compliations.