| 吻合器联合断流术治疗肝硬化门脉高压症的疗效研究 |
| 投稿时间：2010-12-05 点此下载全文 |
| 引用本文：卢凯平,叶再元,邵钦树,王元宇.吻合器联合断流术治疗肝硬化门脉高压症的疗效研究[J].医学研究杂志,2011,40(7):128-130 |
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| 中文摘要:目的总结管状吻合器联合断流术（改良sugiura手术）的经验，并观察治疗肝硬化门静脉高压的临床疗效。方法2000~2010年笔者医院对295例肝硬化门脉高压症伴食管胃底静脉曲张病人分别采用管状吻合器联合断流术（A组）及传统门奇静脉断流术（B组）治疗，A组153例，B组142例，通过术前术后胃镜和上消化道钡餐对比检查和随访，比较两种手术方式治疗食管静脉曲张出血的疗效。结果两组病人均无手术死亡；术后食管静脉曲张完全消失、显著改善和无改善的比率A组：60.12%、39.07%、0.19%；B组：41.03%、48.28%、10.69%；差异有统计学意义(P<0.05)。随访，A、B组静脉曲张复发出血率分别为13/137（9.48%）和46/127（36.37%），差异有统计学意义(P<0.05)；术后肝性脑病发生率：A组2/137 (1.46%），B组9/127（707%）差异有统计学意义(P<0.05),随访5年病死率分别为28/137(20.47%)和31/127(24.41%)，差异无统计学意义(P>0.05)。结论经腹吻合器联合断流术比传统门奇静脉断流术更为彻底，术后消化道出血复发率和肝性脑病发生率明显降低,是一种值得推广的治疗门脉高压的方法。 |
| 中文关键词:断流术 门脉高压 |
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| Abstract:ObjectiveTo review the experience and to evaluate the effect of modified Sugiura procedure for curing portal hypertension. MethodsForm 2000 to 2010,153 portal hypertension patients were treated with the modified Sugiura procedure,compared with 142 patient who received the traditional devascularization. Their clinic data were retrospectively analyzed. ResultsThere was no operative mortality. After the operation, esophagus varicosity vanished completely.The remarkable improvement and the non-improvement ratio in A group were 60.12%, 39.07%, 0.19%,in B group were 41.03%, 48.28%, 10.69%, and the difference had statistical significance.Varicosity recrudescence hemorrhage rate in A and B group respectively was 9.48% and 36.37%， and the difference had statistical significance.Lliver brain illness formation rate in A, B group respectively was 1.46% and 7.07%,and the difference had statistical significance. Within a 5 years of follow-up, the mortality rate respectively was 20.47% and 24.41%. ConclusionThe modified Sugiura procedure can be used widely for it makes the devascularization more completely，has a lower varicosity recrudescence hemorrhage rate and liver brain illness formation rate, compared with the traditional devascularization. |
| keywords:Devascularization Portal hypertension |
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