外科理论与实践2017，Vol.22Issue(6)：504-508,5.DOI:10.16139/j.1007-9610.2017.06.011
腹腔镜选择性门奇静脉断流术治疗门静脉高压症疗效分析
Effects of laparoscopic selective portoazygous devascularization for portal hypertension
摘要
Abstract
Objective To evaluate the safety and effects of laparoscopic splenectomy plus selective portoazygous devascularizationin (LSSD) for the patients with portal hypertension.Methods From January 2012 to December 2014,the clinical data of 127 patients with portal hypertension in our hospital were studied retrospectively.LSSD was performed in 55 patients,and open splenectomy and non-selective portoazygous devascularization(OSSD) in 72 patients.The clinical perioperative data were analyzed.The patients were followed up for one year after LSSD and OSSD.The data on portal hypertension were analyzed including upper gastrointestinal bleeding,the grade of esophageal varices,Child-Pugh score,the diameter of portal vein and portal vein thrombosis.Results Intraoperative blood loss [(243.9±25.1) mL vs (335.9±40.2) mL],postoperative complications (30.9％ vs 51.4％) and hospital stay [(9.5±1.9) d vs (14.2±2.4) d] were significantly less in the patients of LSSD group than in the patients of OSSD group (all P＜0.05).However,operation time was significantly longer in LSSD group [(230.9±24.9) min vs (202.5±30.3) min] (P＜0.001) than in OSSD group.Follow-up after one year of operation showed no upper gastrointestinal rebleeding in LSSD group and 9.7％ in OSSD group (P＜0.05).The patients with severe grade of esophageal varices (9.1％ vs 23.6％),Child-Pugh scores [(7.7±2.0) vs (8.5±2.0)] and the diameter of portal vein [(14.3±0.6) mm vs (14.5±0.5) mm] were significantly lower in LSSD group than in OSSD group (all P＜0.05).There was no significant difference of portal vein thrombosis between two groups (16.4％ vs 29.2％,P＞0.05).Conclusions LSSD is safe and effective in treatment of the patients with portal hypertension.关键词
门静脉高压症/腹腔镜手术/选择性门奇静脉断流术Key words
Portal hypertension/Laparoscopy/Selective portoazygous devascularization分类
医药卫生引用本文复制引用
马洋,孙星..腹腔镜选择性门奇静脉断流术治疗门静脉高压症疗效分析[J].外科理论与实践,2017,22(6):504-508,5.基金项目
国家自然科学基金(81270556) （81270556）
