食管下段胃近端切除术治疗门静脉高压症上消化道出血136例分析

Therapeutic effect of excision of hypomere esophagus and proximal stomach on portal hypertension and upper gastrointestinal bleeding

目的分析食管下段胃近端切除术(Phemister 术)对门静脉高压症上消化道出血的治疗作用。方法对1999年8月至2005年5月我院136例门静脉高压症上消化道出血患者所行Phemister 术进行回顾分析。结果 Phemister 术后静脉曲张明显改善,50.8%完全消失,术后并发症发生率为5.0%,再出血率为4.4%,手术死亡率为1.5%。结论 Phemister 术可有效治疗门静脉高压症上消化道出血并可预防术后再出血,是一种彻底、精确、安全的断流术式,适用于食管、胃底静脉均曲张的门静脉高压症患者。

Objective To analyze the therapeutic effect of excision of hypomere esophagus and proximal stomach （Phemister operation ） on portal hypertension and upper gastrointestinal bleeding. Methods Retrospectively analyze the clinical data of 136 cases treated with the Phemister operation for portal hypertension and upper gastrointestinal bleeding from August 1999 to May 2005. Results Varication of the patients improved markedly, 50.8% of the varication disappeared completely, incidence of complications was 5.0%, rebleeding rate was 4. 4%, mortality rate was 0. 7%. Conclusions The Phemister operation could treat the upper gastrointestinal bleeding and prevent rebleeding effectively in portal hypertension, it is a radical, precise and secure disconnection for portal hypertension with varication in fundus of stomach and esophagus.