急症门-奇静脉断流加脾切除术30例报告

急症门-奇静脉断流加脾切除术30例报告
金立;林擎天;侯宝生;邓磊
【期刊名称】《肝胆胰外科杂志》
【年(卷),期】2011(23)3
【摘要】目的探讨急症门-奇静脉断流加脾切除术对食管、胃底静脉曲张急性出血的治疗效果.方法回顾性分析30例急症门-奇静脉断流加脾切除术的临床资料;全组男25例,女5例,均为肝炎后肝硬化、门静脉高压、食管及胃底静脉曲张急性出血病例,全部均有脾功能亢进表现,肝功能Child A级11例,Child B级19例,前20例施行改良Sugiura式门-奇断流加脾切除术治疗,后10例施行选择性改良Sugiura式门-奇断流加脾切除术治疗.结果全组术后均检出白血球升高,25例血小板计数超300×109/L,25例术后平稳恢复,5例肝功能明显减退,大量腹水、少尿,2例轻度黄疸,经积极治疗全部康复出院.27例(90%)得到1~3年随访,在17例改良Sugiura手术中3例再出血,1例为食管静脉曲张出血,2例为门脉高压性胃病引起,后10例选择性改良Sugiura手术均无再出血表现.结论改良Sugiura门-奇静脉断流加脾切除术是治疗门静脉高压、食管胃底静脉曲张急性出血的有效手术,选择性改良Sugiura式门-奇断流加脾切除术治疗更有其优越性.%Objective To explore the curative effect of porto -azygous vein disconnection plus splenectomy for acute bleeding of easophegal and gastric fundal varices. Methods Clinicl data of 30 patients with porto-azygous veins disconnection plus pleectomy for acute bleeding of easophegeal and gastric fundal varices were analyzed retrospectively All patients were acute esophgel gstric fundal variose bleeding of portl hypertension of post-heptitis insis and all
manifestated splenic hyperfuntion Eleven cases with Child A liver function and Child in 19 cases. Modified Sugiura opertion was performed in 20 cases and selective Sugiur opertion in cases esults There were smooth reoere in 25 ses at postoperti Liver dysfunction with scite and oliguria pperecl in eses light junclice in cases nd ll eses ere recovered through vigors tretment Twenty-seve cases were followed-up for 1～3 years mong cases undergone modified Sugiur opertios rebleeing appered in eses and among 10 cases undergoe eletieugiur pertion no rebleeding cse was found onclusion Modified ugiur operation lu plenectnyis effectie operation for acute beeding of easophegeal and gastric fundal varices elective gi operationplus spleetomy hs the superiority r acute leedig of easophegeal and gast fundal varies
【总页数】3页(P205-207)
【作者】金立;林擎天;侯宝生;邓磊
【作者单位】上海市同仁医院、上海交通大学附属仁济医院长宁区分院,外科,上海,200050;上海交通大学附属第六人民医院,外科,上海,200233;上海市同仁医院、上海交通大学附属仁济医院长宁区分院,外科,上海,200050;上海市同仁医院、上海交通大学附属仁济医院长宁区分院,外科,上海,200050
【正文语种】中文
【中图分类】R619+.1
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