门静脉高压症术后腹腔出血的诊治体会（附23例回顾性分析）

Experience of diagnosis and treatment of intraperitoneal hemorrhage following operation for portal hyper- tension： a retrospective analysis of 23 cases

目的探讨门静脉高压症术后腹腔出血的原因、诊断标准、处理方法以及预后。方法对2004年7月至2010年6月手术治疗门静脉高压症术后腹腔出血23例进行回顾性分析。23例术后腹腔出血病人中，8例为急诊切脾＋断流术后，1例为择期切脾＋近端脾肾分流术后，1例为择期单纯脾切除术后，其余13例均为择期切脾＋断流术。结果23例病人中，非手术治疗1（）例，7例获得治愈；手术治疗13例，8例获得治愈；共8例死亡，死亡原因为腹腔出血、肝功能衰竭、应激性溃疡出血。结论门静脉高压症术后腹腔出血是严重并发症，再手术病死率高，应重视围手术期处理及采取有效的预防措施。

Objective To study the etiology, diagnostic criteria, management and prognosis of intraperitoneal hemorrhage following operation for portal hypertension. Methods The clinical data of 23 cases of intraperitoneal hemorrhage following operation for portal hypertension were analyzed retro- spectively. Results Among these cases, 10 patients received non-operative therapy and the rest 13 pa- tients received operation. Fifteen cases recovered and there were 8 deaths. The dead causes included intraperitoneal hemorrhage, liver failure and hemorrhage secondary to stress ulcer. Conclusion Intrap eritoneal hemorrhage following operation for portal hypertension is a severe complication with high mortality rate for reoperation. We should attach great importance to perioperative managements and take effective preventive measures.