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    • 区域性断流术的临床应用

    Xinlai Guo,Jinxin Huang,Yongkang Yang,Zhuqing Zhou,Tiangeng You,Zhongxin Zhao

    Journal of Abdominal Surgery（2016）

    Cited 0|Views8
    Abstract
    目的 进行区域性断流术40例病人和同期经典贲门周围血管离断术68例病人的资料对比分析,初步评价区域性断流术的疗效.方法 对108例手术病人于断流前、后测定自由门静脉压力(free portal pressure,FPP),进行组内及组间比较.随访1～4年,术后动态比较观察病人的肝功能变化(术前1d、术后第3天、第7天、第14天),腹水感染、肝性脑病发生率,1年再出血率、死亡率.结果 区域性断流术组FPP下降幅度与经典贲门周围血管离断术差异无统计学意义(P＞0.05).区域性断流组病人肝功能1周左右恢复到术前水平;经典贲门周围血管离断术组2周时恢复到术前水平.区域性断流术组平均住院时间为(23.4±6.8)d,术中平均出血量为200 ml,腹水感染率为10.0％,术后1年再出血率为2.5％、死亡率为5.0％;经典贲门周围血管离断术组,平均住院时间为(26.3±16.3)d,术中平均出血量为400 ml,腹水感染率为11.8％,术后1年再出血率为8.8％、死亡率为7.3％.结论 区域性断流术创伤小,术后1年再出血率为5％,近期疗效满意,是治疗门静脉高压症合并上消化道大出血的有效手段之一,特别适合肝功能评分高分值Child-PughB级(Child-Pugh 分级分值11分以上,肝功能检查前白蛋白低于100 mg/L)以及急诊手术的病人.
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    Key words
    Cirrhosis,Portal hypertension,Regional devascularization
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    【要点】：论文对比分析了区域性断流术与经典贲门周围血管离断术的疗效，发现区域性断流术创伤小、恢复快，且适用于特定肝功能评分的病人，具有近期疗效满意的特点。
    

    【方法】：通过对108例手术病人断流前后自由门静脉压力的测定，以及术后肝功能变化、腹水感染率、再出血率和死亡率的动态比较，评估两种手术方法的疗效。
    

    【实验】：实验包括对108例手术病人的临床数据收集，测定自由门静脉压力，并随访1～4年，使用的数据集为病人术前术后肝功能变化及并发症发生率等临床数据，结果显示区域性断流术在术后恢复、住院时间及并发症发生率等方面优于经典贲门周围血管离断术。