保留迷走神经干的选择性断流加大网膜包肾术临床研究

The clinical research of selective pericardial devascularization by preserving vagus trunk plus omentorenopexy

目的比较保留迷走神经干的选择性贲门周围血管离断术加大网膜包肾术(VTP+SPCDV+ORP)和贲门周围血管离断术(PD)对胃肠功能及腹水的影响。方法分析我院普外科治疗门静脉高压症患者98例,分为VTP+SPCDV+ORP组(A组,n=48)和PD组(B组,n=50)两组。比较两组术后胃肠功能回复时间及门静脉高压性胃病(PHG)的发生率及腹水的深度。结果两组术后肛门排气时间分别为(2.45±1.94)d和(4.98±2.56)d,手术后两组PHG发病率分别为47.91%和76.00%,两组手术后腹水深度分别为(2.85±1.66)cm和(4.50±1.38)cm,差异均有统计学意义(均P<0.05)。结论 VTP+SPCDV+ORP组较PD组明显有利于胃肠功能的恢复,可减少PHG的发病率,减少腹水的形成,明显提高患者的生存质量。

Objective To compare the different influence of the selective pericardial devascularization by preserving vagus trunk plus omentorenopexy （VTP ＋ SPCDV ＋ ORP） and pericardial devaseularization （PD） on gastrointestinal function and ascites. Methods 98 cases of portal hypertension were divided into two groups. The group A was treated with VTP ＋ SPCDV ＋ ORP named VTP ＋ SPCDV＋ORP group （n=48）. The group B was treated with PD named PD group （n= 50）. The postoperative gastrointestinal function recovery time and rates o{ portal hypertension gastropa- thy （PHG） and the depth of ascites were obseved. Results The postoperative anal exhaust time of group A and group B were 2.45±1.94 vs 4.. 98± 2.56. The postoperative incidence of PHG in group A and group B were 47.91% vs 76.00%. The ascites depth of group A and group B were 2.85±1.66 vs 4.50±1.38. Conclusion VTP ＋ SPCDV ＋ ORP is significantly beneficial to the recovery of gastrointestinal function, which can reduce the incidence of PHG and as- cites and improve the quality of life significantly.