贲门周围血管离断并胃底粘膜下血管环扎术治疗门静脉高压症出血的体会

Pericardial devascularization plus submucous varicose trans-ligation in the fundus of stomach for the treatment of bleeding varix

目的 探讨门静脉高压症并发出血的治疗方法。方法 回顾性分析 10 8例贲门周围血管离断并胃底粘膜下血管环扎术的临床资料。结果 手术总死亡率为 7 4%。 90例获得随访 ,随访 3年期间死亡 9例 ,再出血率为 2 1%。手术操作较简单 ,针对性强 ,适用于基层医院和急诊手术 ,但急诊手术死亡率高于择期手术。主要死亡原因是肝功能恶化及其并发症。结论 提高疗效的关键是断流要彻底 。

ObjectiveTo evaluate the surgical therapy for bleeding gastroesophageal varix.Method108 cases of portal hypertension were treated by pericardial devascularization plus submucous varix transligation in the gastric fundus.Postoperative follow-up was made in 90 cases.ResultPostoperative mortality was 7.4% (8 cases), and 9 cases died of rebleeding during the followed-up of 3 years.The rebleeding rate was 21%. The mortality rate of emergent operation was greater than elective surgery.ConclusionThe surgical procedure is satisfactory in the management of bleeding varix especially on elective basis, when the protocol is strictly observed.