脾肾分流并贲门周围血管离断术治疗肝硬化门静脉高压症疗效分析

Curative effect analysis of splenorenal shunt combined with cardia peripheral vessels mutilation on portal hypertension

目的探讨脾肾分流并贲门周围血管离断术治疗门静脉高压症的临床疗效。方法收集我院144例2种手术方式病例,回顾性分析研究外科手术治疗门静脉高压症病例,总结和比较手术疗效,并探讨提高手术疗效的措施。结果联合手术组:无近期再出血,手术死亡率3.4%,远期再出血率6.9%、肝性脑病发生率3.4%,术后1,3,5,10 a生存率分别为96.6%,92.6%,79.2%,58.3%。断流术组:手术死亡率4.6%,远期再出血率为14.9%、肝性脑病发生率5.7%,术后1,3,5,10 a生存率分别为95.4%,87.9%,75%,53.8%。结论联合手术能达到优势互补的目的,在门静脉高压症的治疗中是比较合理的,且有一定临床实用价值。

Objective It is to discuss the clinical curative effect of splenorenal shunt combined with cardia peripheral vessels mutilation on portal hypertension. Methods 144 patients with portal hypertension in our hospital who were treated with two kinds of operation modus were collected and analyzed retrospectively. The operation curative effect was summarized and compared. The measures of raising clinical curative effect were discussed. Results In association operation group, there was no short term rebleeding, the operative mortality was 3.4%, the long term rebleeding rate was 6.9%, the hepatic encephalopathy incidence rate was 3.4% and the postoperative survival rate of 1, 3, 5, 10-year was 96.6%, 92.6%, 79.2 %, 58.3 % respectively. In disconnection group, the operative mortality was 4.6 %, the long term rebleeding rate was 14.9 %, the hepatic encephalopathy incidence rate was 5.7 % and the postoperative survival rate of 1, 3, 5, 10-year was 95.4 %, 87.9 %, 75 %, 53.8 % respectively. Conclusion Association operation can achieve the purpose of complement each other＇s superiority. It is rational to use in the treatment of portal hypertension and has definite clinical utility value.