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保留迷走神经干门奇静脉断流加分流术治疗门静脉高压症28例分析
Treatment of portal hypertension with combined vagus trunk-preserving portoazygous devascularization and shunting: Report of 28 cases
文章发布日期:2013年05月04日  来源:  作者:简以增,童庆东,余强锋  点击次数:2968次  下载次数:626次

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【摘要】:目的探讨保留迷走神经干门奇断流加分流术(VTPPDS)治疗门静脉高压症的疗效。方法对比分析我院2005年至2011年28例VTPPDS(n=28)和30例门奇断流加幽门成形术(PD+PP;n=30)治疗门静脉高压症的临床资料,对两组资料术后胃肠功能恢复(术后72 h内)、术后腹胀、再出血、腹水变化、住院时间(14 d内出院)采用卡方检验进行统计分析。结果VTPPDS治疗组,27例治愈,1例死于肝衰竭。与PD+PP对照组对比,VTPPDS治疗组术后胃肠功能恢复明显更快(60.0 vs 85.7%,P<005),食后腹胀率(43.3% vs 7.1%,P<0.01),及再出血率(26.7% vs 7.1%,P<0.05)均更低,腹水减少或消失率(62.5% vs 955%,P<0.01)更高,住院时间更短(53.3% vs 78.6%,P<0.05)。结论VTPPDS术式是治疗门静脉高压症的有效手术方法,并且术后效果比PD+PP术式更具优越性。
【Abstract】:ObjectiveTo investigate the therapeutic outcome of surgical intervention with combined vagus trunk-preserving portoazygous devascularization and shunting (VTPPDS) to treat patients with portal hypertension. MethodsThe clinical data of portal hypertension patients who underwent VTPPDS (n=28) or portoazygous devascularization in combination with pyloroplasty (PD+PP; n=30) in our hospital from 2005 to 2011 were collected for comparative analysis. The statistical significance of differential rates of gastroenteric function recovery (within 72 hrs post-surgery), postoperative ventosity and postoperative hemorrhage, status of ascites, and length of hospital stay (discharge within 14 days) were compared between the two groups using the Chi-squared test. ResultsIn the VTPPDS group, 27 patients were cured and one patient died of liver failure. When compared to the PD+PP group, the VTPPDS group showed significantly earlier recovery of gastroenteric function (60.0% vs. 85.7%, P<0.05), lower incidences of postoperative ventosity (43.3% vs. 7.1%, P<0.01) and postoperative hemorrhage (26.7% vs. 7.1%, P<0.05), higher incidences of ascites reduction/disappearance (62.5% vs. 95.5%, P<0.01), and shorter length of hospital stay (53.3% vs. 78.6%, P<0.05). ConclusionThe VTPPDS procedure is an effective surgical method to treat portal hypertension, and provides superior post-operative outcomes to the PD+PP procedure.
【关键字】:肝硬化;高血压,门静脉;迷走神经;门奇静脉断流加分流术
【Key words】:liver cirrhosis; hypertension, portal;vagus nerve;portoazygous devascularization
【引证本文】:

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