选择性贲门周围血管离断术的临床应用探讨

Application of selective devascularization for the treatment of portal hypertension

目的探讨选择性贲门周围血管离断术的临床应用效果。方法回顾性分析我院2010年1月至2013年8月86例肝硬化门脉高压接受断流手术患者的临床资料,按手术方式将其分为选择性断流组和传统断流组,对比2组的手术情况、术后肝功能指标、术后并发症情况。结果选择性断流组手术时间延长,FFP术后降低明显(P<0.05),出血量和输血例数2组间无统计学差异(P>0.05);选择性断流组术后ALT和AST峰值、并发症发生率均低于传统断流组(P<0.05);选择性断流组平均术后住院时间较传统断流组缩短(P<0.05)。结论选择性断流术能够更有效降低门静脉压力、减少术后近期并发症,值得临床推广。

Objective To determine efficacy of selective devascularization in management of portal hypertension. Methods The clini-cal data of 86 patients of portal hypertension in our hospital from Jan. 2010 to Aug. 2013 were retrospectively analyzed. The patients were divided into the selective group and the nonselectove devascularization group according to the different devascularization ways. The postopera-tive liver function index and complications were analyzed. Results In selective devascularization group, the surgery time was prolonged （P〈0. 05）, the postoperative FPP was reduced （P〈0. 05）, and there was no difference in bleeding volume and blood transfusion cases （P〉0. 05）. The postoperative peak value of ALT and AST and postoperative pomplications in the selective devascularization group were low-er than those in the nonselectove devascularization group （P〈0. 05）. And patients in the selective devascularization group have a shorter hospital stay compared to the nonselectove devascularization group （P〈0. 05）. Conclusion Selective devascularization can lower free portal pressure more effectively, reduce incidence rates of postoperative early complications, and it is worthy of clinical promotion.