贲门周围血管离断术治疗门脉高压急性大出血39例

目的探讨脾切除联合贲门周围血管离断术对治疗门脉高压引发的急性上消化道大出血的临床疗效。方法对2010年1月-2012年12月湖南省溆浦智德医院收治的39例门脉高压急性大出血首次施行脾切除联合贲门周围血管离断术的患者进行回顾性分析。结果手术后有效止血率为100%,术后并发症发生6例(15.4%)。术后14天肝功能(Alt、Ast、TBIL、TP、TBA)、血常规(RBC、HB、WBC、PLT)均有明显改善,差异有统计学意义(P<0.05);手术后门静脉压显著降低,差异有统计学意义(P<0.05)。结论贲门周围血管离断术治疗门脉高压急性上消化道大出血临床效果理想,肝功能恢复良好,并发症少,值得临床推广应用。

Objective To observe the clinical therapeutic efifcacy of splenectomy combined with pericardial devascularization in treatment of portal hypertension associated with acute upper digestive tract hemorrhage. Methods 39 cases in our hospital from January 2010 to January 2012 of treating portal hypertension associated with acute upper digestive tract hemorrhage by splenectomy combined with pericardial devascularization were analyzed retrospectively. Results The total effective hemostasia rate was 100%,and the postoperative complications rate was 15.4%. There were signiifcant deviations among the index（P〈0.05） of the liver function, blood routine and portal vein pressure. Conclusion Splenectomy combined with pericardial devascularization in treatment of portal hypertension associated with acute upper digestive tract hemorrhage has a vital role to play, liver function has been improved signiifcantly,the postoperative complications rate is low, and consequently it’s worthy to spread in clinical application continually.