肝硬化门静脉高压上消化道出血的手术治疗

Surgical treatment experience of cirrhotic portal hypertension upper gastrointestinal bleeding

目的对比分析不同外科术式治疗肝硬化门静脉高压上消化道出血患者的疗效。方法选择2010年8月至2011年9月期间收治的符合外科手术治疗指征的肝硬化门静脉高压上消化道出血患者104例作为研究对象,在上述患者入院确诊后立即给予外科手术治疗,其中39例患者接受门体静脉分流术,23例患者接受断流术,42例患者接受分流断流联合术,对比分析上述三组患者的疗效。结果门体静脉分流术组治愈率与分流断流联合术组相比差异无统计学意义(P>0.05);门体静脉分流术组、分流断流联合术组的治愈率显著高于断流术组(P<0.05)。结论分流断流联合术、门体静脉分流术治疗肝硬化门静脉高压上消化道出血患者的疗效较断流术为佳,分流断流联合术吸取了两种术式的长处,因此是治疗肝硬化门静脉高压上消化道出血的常规首选术式。

Objective To compare the effects of different surgical procedures on cirrhotic portal hypertension patients with upper gastrointestinal bleeding.Methods From August 2010 to September 2011,104 patients with cirrhotic portal hypertension upper gastrointestinal bleeding according with surgical treatment indications were choosed as the research objects,the patients were given surgical treatment immediately after diagnosis,patients received portal systemic stent shunt,23 patients underwent operation flow,42 patients received shunt flow joint operation.The curative effects of the three groups were compared.Results There was no significant difference in the cure rates between the portosystemic stent shunt group and the shunt flow joint operation group（P〉0.05）;The cure rates of the portosystemic stent shunt group and the shunt flow joint operation group were significantly higher than that of the shunt flow joint operation group（P〈0.05）.Conclusion The curative effects of shunt flow joint operation and portosystemic stent shunt operation on cirrhotic portal hypertension patients with upper gastrointestinal bleeding are better than that of operation flow.Shunt flow joint operation has the strong points of the other two kinds of operation,so is the first choice to treat cirrhotic portal hypertension upper gastrointestinal bleeding.