| 扩大贲门周围血管离断术治疗门静高压食管静脉曲张破裂出血 |
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| 引用本文： | 林木生,包仕廷,刘运奇.扩大贲门周围血管离断术治疗门静高压食管静脉曲张破裂出血[J].湛江医学院学报,1997(1). |
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| 作者姓名： | 林木生 包仕廷 刘运奇 |
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| 作者单位： | 广东医学院附属医院外科!湛江，524001，广东医学院附属医院外科!湛江，524001，广东医学院附属医院外科!湛江，524001 |
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| 摘 要： | 目的：探索一种更有效防止门静脉高压症术后再出血方法的改良术式。方法：采用扩大贲门周围血管离断术（扩大术）治疗69例和贲门周围血管离断术（Hassab术）治疗53例（对照）。结果：Hassab术组术后近、远期出血率分别为9．4％和21．5％，明显高于扩大术组的0和5．6％（P＜0．05）；术后食管静脉曲张消失Hassab术组为18.2％，明显低于扩大术组的40．5％（P＜0．05），且术后食管静脉曲张无改变6例均为Hassab术组的患者；术后随访，扩大术组3年生存率比Hassab术组高。本组急症手术死亡率为17．1％明显高于择期手术死亡率的2．3％（P＜0．01）；肝功能按Child分级C级者手术死亡率为26.3％，明显高于A、B级的2.9％（P＜0.01）。扩大术组术后胃排空障碍发生率稍高，但差异无显著性。结论：扩大贲门周围血管离断术比Hassab术的近、远期疗效为优；急症断流术或（和）肝功能C级者手术效果欠佳。
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| 关 键 词： | 高血压 门静脉 贲门周围血管 门奇静脉断流术 |
EXTENDED HASSAB'S PROCEDURE FOR ESOPHAGEAL VARICES DUE TO PORTAL HYPERTENSION |
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| Lin Musheng, Bao Shiting, Liu Yunqi.EXTENDED HASSAB''''S PROCEDURE FOR ESOPHAGEAL VARICES DUE TO PORTAL HYPERTENSION[J].Journal of Guangdong Medical College,1997(1). |
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| Authors: | Lin Musheng Bao Shiting Liu Yunqi |
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| Abstract: | Objective: In order to search a more effective management to lower the chance of esophageal varices rebleeding after surgery for portal hypertension. Method: Azygoportal disconnection by extended Hassab's procedure in 69 cases,and by Hassab's procedure in 53 cases as control. Results: After operation the short-term and long-term rebleeding rates were obviously higher (P<0. 05)in Hassab's group with 9. 4 % and 21. 5% than those in extended Hassab's group with 0% and 5. 6%, respectively. It was only the 6 patients who had undergone Hassab's procedure that showed no postoperative change in the esophageal varicosis. The rates of 3-year survival and of gastric emptving disorder were higher in extended Hassab's group than those in Hassab's group. The mortality(17. 1%) after emergency operation is much higher than that (2. 3%) after selective operation(P<0. 01). Patients with liver function graded Child C had a mortality of 26. 3% which is significantly higher(P<0. 01) than that (2. 9%) observed in those with liver function of Child A or B. Conclusion: The short and long-term results in extended Hassab's procedure are better than those in Hassab's operation. The benefit given by the emergency operation or by operation on those with liver function of Child C is not of much to patients. |
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| Keywords: | hypertension portal vein pericardial vessel azygoportal disconnection |
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