返回 2008年第31卷第3期 目录

经腹贲门周围血管离断术联合附加限制环的门腔静脉分流术

治疗门脉高压症的临床研究

方 宏，韩江涛

(宜宾市第一人民医院普外科，四川宜宾 644000)

摘 要 目的：探讨不同术式对肝硬变门脉高压上消化道大出血的外科治疗效果。方法：对Child肝功能分级主要为A级及B级的肝硬化门脉高压上消化道大出血患者59例随机采用3种术式,分别为经腹贲门周围血管离断术(简称为经腹断流术)22例,附加限制环的门腔静脉分流术(简称为附加分流术)17例,经腹贲门周围血管离断术联合附加限制环的门腔静脉分流术(简称联合术式)20例。结果：术后均获随访10~36月，平均23月，联合术式术后再出血率明显降低（P<0.05）。结论：经腹贲门周围血管离断术联合附加限制环的门腔静脉分流术弥补了单一术式的不足，可明显降低术后再出血率，操作简便，不失为一种较好的手术术式。

关键词 肝硬变；门脉高压；经腹断流术；附加分流术

STUDY OF THE TREATMENT OF PORTAL HYPERTENSION BY TRANSABDOMINAL EXTENSIVE ESOPHAGOGASTRIC DEVASCULARIZATION COMBINED PORTACAVAL SHUNT PLUS LIMITING RING AROUND
THE ANASTOMOSIS

Fang Hong,et al

Department of General Surgery, the First People's Hospital of Yibin City

Abstract Objective：To explore the effect of different operational modes on portal hypertension with hemorrhage of upper digestive tract. Methods：Three operation modes were applied randomly to 59 portal hypertension patients whose Child grade of hepatic function was mainly A or B: transabdominal extensive esophagogastric devascularizaion (transabdominal devascularization), 22 cases. Portacaval shunt plus limiting ring around the anastomosis (appended portacaval shunt ),17 cases. Transabdominal extensive esophagogastric devascularizaion combined with portacaval shunt plus limiting ring around the anastomosis (combined operation),20 cases. Results：All the cases were followed-up at intervals after operation for 10~36 months , average 23 months .The rate of rehemorrhage in combined operation group was significantly lower than that in the other groups（P<0.05）. Conclusion:Transabdominal extensive esophagogastric devascularization combined with portacaval shunt plus limiting ring around the anastomosis could make up for the defect from a single operation mode and decrease significantly the rate of rehemorrhage. It was easy to operate and was a good operation mode to a certain degree.

Key words Liver cirrhosis； Portal hypertension； Transabdominal devascularization； Added portacaval shunt