选择性断流术和联合断流术治疗门静脉高压症的疗效对比

Comparison of efficacy between selective devascularization and combined devascularization in the treatment of portal hypertension

目的比较选择性断流术和联合断流术对门静脉高压症的临床疗效。方法选择2001年3月至2012年3月在本院治疗的门静脉高压症患者105例,按照术式分为A组和B组。A组53例接受选择性断流术治疗,B组52例接受联合断流术治疗,比较2组术后自由门静脉压力和术后再出血以及其他并发症的发生率。结果 2组患者术后自由门静脉压力(FPP)均显著下降(P<0.05),但A组患者术后FPP下降程度明显大于B组(P<0.05),A组患者食管下段曲张静脉直径、再出血发生率及其他并发症发生率均显著低于B组(P<0.05)。结论与联合断流术相比,选择性断流术治疗门静脉高压症的效果更显著,并发症少,是更理想的手术方法。

Objective To compare the clinical efficacy of selective devascularization and combined devascularization in the treatment of portal hypertension.Methods One hundred and five patients with portal hypertension who were treated in our hospital from March 2001 to March 2012were divided into group A and group B based on surgical procedures.Group A （n =53） underwent selective devascularization and Group B （n =52） underwent combined devascularization.The postoperative free portal pressure and the incidence of postoperative bleeding and other complications after surgery were compared.Results Postoperative free portal pressure （FPP） in the two groups significantly decreased （P ＜ 0.05）,but FPP of group A decreased more markedly than that of group B （P＜0.05）.The incidence of lower esophageal varicose vein diameter,bleeding and other complications of group A were significantly lower than those of group B （P ＜ 0.05）.Conclusion Compared with combined devascularization,selective devascularization had good effect and fewer complications in the treatment of portal hypertension,and is a better surgical method.