原位脾切除联合选择性断流术治疗门脉高压症43例分析

The analysis of the efficacy of orthotopic splenectomy combined with selective portal-azygous disconnection for treating portal hypertension: a report of 43 cases

目的总结和分析原位脾切除加选择性门奇断流术对肝硬化合并门静脉高压症的疗效。方法回顾性分析2007年1月至2014年1月间连云港市第一人民医院43例肝硬化门静脉高压病人采用原位脾切除加选择性门奇断流术的资料,探讨其疗效。结果全组并发症发生率46.5%(22/43),死亡2例,其余病例经治疗后恢复良好。结论原位脾切除加选择性门奇断流术治疗门静脉高压效果好。应合理掌握手术适应症及手术时机,彻底断流,熟练掌握手术的技术要点,防止并发症的发生。

Objective We were to summarize and analyze the efficacy of orthotopic splenectomy combined with selective portal-azygous disconnection for treating portal hypertension.Methods A retrospective analysis was made on the results of 43 patients, with hepatocirrhosis and portal hypertension, who received the treatment of orthotopic splenectomy combined with selective portal-azygous disconnection during Jan2007 and Jan2014.Results The rate of complications was 46.5% （22/43）.Two cases were dead,the others recovered well after the treatment.Conclusions The effect of selective portal -azygous disconnection combined with orthotopic splenectomy for treating portal hypertension appears to be effective.In order to improve the operate result,the following should be emphasized：the selection of the operative opportunity and indications, thorough porta-azygous disconnection and the performance of the operation in according to the corrective technique, prevention of surgical complications.