联合断流术治疗门脉高压并发上消化道出血的疗效分析

Clinical analysis of the combined esophagogastric devascularization in the treatment of patients with portal hypertension combined upper alimentary canal haemorrhage

目的 观察经腹联合断流术治疗门脉高压并发上消化道出血的临床疗效。方法 30例确诊为肝炎性肝硬化门静脉高压症患者的,随机分为两组各15例,对照组患者行外科断流术治疗,实验组患者采用断流术加胃底黏膜下血管阻断的经腹联合断流术治疗,比较两组患者的临床效果。结果 两组均无死亡病例发生;实验组患者并发顽固性腹水、肝性脑病、门静脉系统血栓形成情况均低于对照组,差异有统计学意义(P<0.05);实验组随访期间累计上消化道再出血发生率低于对照组,差异有统计学意义(P<0.05)。结论 经腹联合断流术治疗门脉高压上消化道出血的临床效果满意,能够有效降低手术并发症、降低术后再出血率。

Objective To explore the safety and efficacy of the combined esophagogastric devascularization in the treatment of patients with portal hypertension combined upper alimentary canal haemorrhage.Methods 30 cases of portal hypertension patients were randomly divided into 2 groups.Every group have 15 cases.The control group took the devascularization.The experiment group took the combined esophagogastric devascularization.Results Both groups had no deaths occurred;the ascites,hepatic encephalopathy,portal vein thrombosis system in experiment group were lower than control group,the difference were statistically significant（P 〈 0.05）;the incidence of accumulated upper gastrointestinal bleeding during follow-up in experiment group was lower than control group,the difference was statistically significant（P 〈 0.05）.Conclusion Combined esophagogastric devascularization is a safe operation for upper digestive tube hemorrhage resulted from portal hypertension.