门脉高压性胃病上消化道出血的外科治疗

Portal Hypertension Sex Stomach Trouble Upper Gastrointestinal Bleeding of Surgery

目的探讨门脉高压性胃病(PHG)上消化道出血的外科治疗。方法回顾性分析我院2006年4月至2011年12月收治入院的门脉高压性胃病上消化道出血的外科治疗患者20例临床资料。根据治疗方法不同分为两组,10例采用保留迷走神经主干门奇断流术(VTPPD组)和10例采用贲门周围血管离断术(PD组)的进行临床治疗,并对两组手术前后PHG的发病率、PHG加重病例比率分别予以比较。结果两组食道胃底静脉曲张皆明显减轻或消失。VTPPD组术后为60%(6/10),PD组术后PHG为80%(8/10),手术后VTPPD组PHG发病率低于PD组(P=0.048)。PHG程度加重者VTPPD组2例(20%,2/10),PD组4例(40%,4/10),发生率差异有统计学意义(P=0.027)。结论 VTPPD较传统的断流术明显减少PHG的发病率,并可明显减轻加重程度。

Objective To study the portal hypertension sex stomach trouble（PHG） upper gastrointestinal bleeding of surgery.Methods Retrospective analysis in April 2006-December 2011 hospital were the portal hypertension sex stomach trouble upper gastrointestinal bleeding 20 cases of surgical treatment for patients with clinical data.10 cases by the keep the vagus nerve trunk door flow＇s technique（VTPPD） and 10 cases by the upper peripheral vascular technique（PD） break away from the clinical treatment,and in two groups before and after operation the incidence of PHG,increased PHG cases shall be more rate.Results Two groups of stomach esophagus varicosity are significantly reduce or disappear.After VTPPD group was 60%（6/10）,PD group began PHG was 80%（8/10）,and after surgery VTPPD group PHG incidence below PD group（P=0.048）.The increasing PHG VTPPD group 2 cases（20%,2/10）,PD group 4 cases（40%,4/10）,incidence is statistically significant difference（P=0.027）.Conclusion VTPPD a cutoff of the traditional art significantly reduce the incidence of PHG,and can significantly reduce the degree increase.