Application of pericardial devascularization and omental packing combined with gastric noose cerclage in treatment of portal hypertension
-
摘要:
目的探讨贲门周围血管离断术加大网膜填胸包肾术联合胃底绞索环扎术在门静脉高压症治疗中的应用。方法回顾性分析2007年6月-2013年6月南通大学附属南通三院收治的59例行脾切除贲门周围血管离断术加大网膜填胸包肾术及胃底绞索环扎术的门静脉高压症患者的临床资料,观察手术前后门静脉压力、门静脉内径、肝功能的变化及术后再出血率、生存率等指标。计量资料多组间比较采用方差分析,两组间比较采用配对t检验。结果 59例患者手术顺利,术后门静脉压力较术前明显下降,急诊手术后上消化道出血停止,无胃瘫、胰瘘等并发症,无手术死亡病例。术后随访25年,再出血1例,死亡1例。结论贲门血管离断术加大网膜填胸包肾术联合胃底绞索环扎术综合了断流术和分流术的优点,达到彻底离断食道下段、贲门、胃底周围血管及胃壁黏膜下血管,止血确切,术后并发症少,再出血率低,操作简单,是一种合理可靠、安全有效的手术方式。
Abstract:Objective To investigate the application of pericardial devascularization and omental packing combined with gastric noose cerclage in the treatment of portal hypertension. Methods The clinical data of 59 patients who were treated in our hospital and received pericardial devascularization and omental packing combined with gastric noose cerclage from June 2007 to June 2013 were analyzed retrospectively,and the indices such as changes in portal venous pressure,portal vein diameter,and liver function after surgery,postoperative rebleeding rate,and survival rate were observed. Analysis of variance was applied for comparison between multiple groups,and paired t- test was applied for comparison between two groups. Results All the 59 patients received a successful surgery,and the portal venous pressure was significantly decreased after the surgery; after the emergency operation,upper gastrointestinal bleeding was stopped,with no complications such as gastroparesis and pancreatic fistula; there was no death. The postoperative follow- up was performed for 2 ~ 5 years,and 1 case of rebleeding and 1 death occurred. Conclusion Pericardial devascularization and omental packing combined with gastric noose cerclage have the advantages of both devascularization and shunt,and can achieve complete devascularization of the vessels at the lower segment of the esophagus,the cardia,and the gastric fundus,and the submucosal vessels in the gastric wall,with exact hemostasis,few postoperative complications,low rebleeding rate,and simplicity in operation,which is a reasonable,reliable,safe,and effective operation method.
-
Key words:
- hypertension,portal /
- digestive system surgical procedures
-

计量
- 文章访问数: 1621
- HTML全文浏览量: 12
- PDF下载量: 389
- 被引次数: 0