脾腔分流联合断流术治疗门脉高压症上消化道出血的疗效观察

Curative Effect Observation on the Treatment of Portal Hypertension and Upper Gastrointestinal Bleeding by Splenic Shunt Combined with Devascularization

目的总结脾腔分流联合断流术治疗门脉高压症上消化道出血的疗效及经验。方法对38例门脉高压症上消化道出血患者行脾腔静脉端侧吻合联合贲门周围血管离断术治疗。结果38例患者手术顺利完成并好转出院，无手术死亡病例，术后近期无出血，术后随访1—5年，平均4．2年，再出血1例（2．6％），无肝性脑病发生，5年生存率为97．4％。结论脾腔分流联合断流术治疗门脉高压症上消化道出血疗效肯定，是一种合理、可靠、安全的手术方式。

Objective To summarize curative effect and experiences of treatment of portal hypertension and upper gastrointestinal bleeding by splenic shunt combined with devascularization. Methods All 38 cases of patients with portal hypertension and upper gastrointestinal bleeding were cured by side and end anastomosis of splenic intravenous combined with amputation surgery of pericardial vascular. Results Surgery of 38 patients were successful and recovery. There were no operative deaths and no postoperative bleeding. Patients were followed up 1 to 5 years （average of 4.2 years ） and 1 case of re-bleeding was found （2.6%）. There were no hepatic encephalopathy and 5-year survival rate was 97.4%. Conclusion Splenic shunt combined with devascularization for the treatment of portal hypertension and upper gastrointestinal bleeding has a positive effect. The method was a reasonable, reliable and safe surgical procedure.