改良Sugiura术治疗门静脉高压70例分析

Improved Sugiura operation for portal hypertension： A report of 70 cases

目的探讨改良Sugiura术治疗门静脉高压症引起的食管下端胃底曲张静脉破裂出血的安全性和有效性。方法对我院2004年1月至2010年8月治疗的70例门静脉高压症并出血的病例进行回顾性总结分析。结果术前自由门静脉压力为（38．71±7．71）cmH2O，断流术后为（32．33±7．61）cmH2O，二者相比差异有统计学意义（P〈0．05）。10例急诊手术，止血率达90％。围手术期死亡3例，30例少量腹水，胸腔积液20例，门静脉血栓8例。术后消化道再出血7例，其中1例为急诊手术患者。结论改良Sugiura术是治疗门静脉高压症引起的食管下端胃底曲张静脉破裂出血的是一种安全、有效的方法。

Objective To investigate the safety and efficacy of improved Sugiura operation in the treatment of esophagogastric variceal bleeding caused by portal hypertension. Methods The clinical data of 70 patients who underwent the improved Sugiura operation in our hospital from January 2004 to August 2010 were retrospectively analyzed. Results The free portal pressure （FPP） was 32.33 ± 7.61 cmH2O postoperatively, significantly lower than 38.71 ± 7.71 cmH2O preoperatively with difference being significant（P 〈0.01 ）. The rate of hemostasis in 10 emergency operations was 90%. Three patients died during perioperative period. Thirty patients developed ascites, 20 pleural effusion and 8 portal vein thrombosis. Seven patients were complicated with rehemorrhage, in which one underwent emergency operation. Conclu- sion The improved Sugiura operation is a safe and effective surgical procedure in the treatment of esopha- gogastric variceal bleeding caused by portal hypertension.