脾切除联合贲门周围血管离断术治疗门脉高压症并消化道大出血效果观察

Application effect of splenectomy combined with cardiac peripheral vascular disconnection in patients with portal hypertension and massive hemorrhage of digestive tract

目的观察脾切除联合贲门周围血管离断术在门脉高压症并消化道大出血患者的的应用效果,分析其应用价值。方法选取2015年1月—2016年5月治疗的门脉高压症并消化道大出血患者45例作为研究对象,随机分为实验组25例和对照组20例,对照组采取贲门周围血管离断术进行治疗,实验组采取脾切除联合贲门周围血管离断术进行治疗,观察两组治疗效果,数据进行统计学处理,P<0.05为差异有统计学意义。结果实验组治疗后治愈率为96.0%,病死率为4.0%,手术止血率为92.0%,术后再出血率为8.0%,术后并发症总发生率为16.0%;对照组分别为65.0%、35.0%、60.0%、40.0%和45.0%,两组比较差异均有统计学意义(均P<0.05)。结论脾切除联合贲门周围血管离断术在门脉高压征并消化道大出血的应用效果显著,具有一定的临床价值。

Objective To observe the effect of splenectomy combined with cardiac peripheral vascular disconnection in patients with portal hypertension and hemorrhage of digestive tract, and to analyze its application value. Methods 45 patients with portal hypertension and massive hemorrhage of digestive tract in our hospital between January 2015 and May 2016 were selected as study subjects, and randomly divided into the experimental group and control group. Patients in the control group were treated with cardiac peripheral vascular disconnection, patients in the experimental group were treated with splenectomy combined with cardiac peripheral vascular disconnection. Treatment effects were compared between two groups. The data was statistically managed and compared, if P〈0.05, difference have statistical sense. Results In the experimental group, the cure rate was 96.0%, the mortality rate was 4.0%, the rate of surgical hemostasis was 92.0%, the rate of postoperative bleeding was 8.0%, and the incidence rate of postoperative complications was 16.0%. In the control group, the cure rate was 80.0%, the mortality rate was 20.0%, the rate of surgical hemostasis was 92.0%, the postoperative bleeding rate was 75.0%, and the incidence rate of postoperative complications was 25.0%. The differences of cure rate, mortality, surgical hemostasis rate, postoperative bleeding rate and the incidence of postoperative complications between two groups were statistically significant （P〈0.05）. Conclusion The application effect of splenectomy combined with cardiac peripheral vascular disconnection in patients with portal hypertension and massive hemorrhage of digestive tract was obvious. The treatment has an important clinical value.