门奇断流联合脾切除+大网膜包肾术治疗门脉高压症食管胃底静脉破裂大出血的临床研究

Pericardial Devascularization Plus Splenectomy and Omentum Wrapped Kidney for the Treatment of Portal Hypertension Esophageal Variceal Hemorrhage Clinical Research

目的研究门脉高压症食管胃底静脉破裂急性大出血临床合理的手术治疗方法及其临床效果。方法选取该院78例肝硬化门脉症食管胃底静脉急性破裂大出血患者,分为两组分别采用门奇断流联合脾切除、大网膜包肾术和常规断流分流手术治疗肝硬化门脉症食管胃底静脉破裂大出血。对患者满意度、并发症、再出血、治疗前和治疗后各项肝功能指标进行统计。结果观察组的患者满意度明显高于对照组(?2=4.69),并发症发生率明显小于对照组(?2=9.36),P<0.05,差异均有统计学意义。治疗后患者各项肝功能指标的较治疗前明显好转,治疗后观察组各指标均比对照组好转明显,且P<0.05,差异有统计学意义。结论采用门奇断流联合脾切除加大网膜包肾术治疗门脉高压症食管胃底静脉急性破裂大出血是比较理想的一种急诊手术方法。

Objective To study the portal hypertension esophageal variceal acute massive hemorrhage clinical reasonable operation treatment method and clinical effect. Methods in our hospital 78 cases of portal cirrhosis patients with esophageal gastric fundus vein acute rupture hemorrhage patients, divided into two groups respectively by means of portal azygous disconnection with splenectomy, omental transposition and conventional treatment of portal devascularization shunt operation for patients with esophageal and gastric variceal bleeding. For the satisfaction of patients, complications, bleeding, before and after treatment liver function indicators for statistical. Results in the observation group, the patients’satisfaction was significantly higher than the control group （c2=4.69）, the rate of complications was significantly lower than that of control group （c2=9.36）, are P〈0.05, with significant difference. After treatment of patients with liver function indexes were significantly improved after treatment, after treatment, observation group each indicators than group improved significantly, the control and the P〈0.05, with significant difference.Conclusion This method is an ideal method in emergency operation.