论文部分内容阅读
目的探讨近端胃切除加脾切除术在肝硬化门脉高压所导致的食管胃底曲张静脉破裂出血治疗中的临床疗效。方法对46例肝硬化门脉高压上消化道出血患者行近端胃切除加脾切除术,观察患者手术前后、随访期间血细胞、肝功能、凝血、免疫功能的变化,术后并发症、死亡率、再出血率等。结果手术后患者体重、凝血时间、免疫蛋白、补体C3等变化不明显,手术后白细胞、血小板升高明显,随访期间均持久稳定。术后并发症少。术后死亡率4.35%;再出血率2.17%。结论肝硬化门脉高压及所导致的食管胃底曲张静脉破裂出血,行近端胃切除加脾切除术对改善肝功能、纠正脾功能亢进、减少再出血率及死亡率等效果显著。
Objective To investigate the clinical effect of proximal gastrectomy and splenectomy on the treatment of esophageal and gastric variceal bleeding caused by cirrhosis and portal hypertension. Methods Forty-six patients with portal hypertension and upper gastrointestinal bleeding underwent proximal gastrectomy and splenectomy. The changes of blood cells, liver function, blood coagulation and immune function before and after operation were observed. The postoperative complications, mortality rate , Re-bleeding rate and so on. Results The body weight, clotting time, immune protein, complement C3 and other changes were not obvious after operation. The white blood cells and platelets increased significantly after operation, and were stable in the follow-up period. Postoperative complications less. Postoperative mortality was 4.35%; the rate of rebleeding was 2.17%. Conclusions Portal hypertension of liver cirrhosis and esophageal and gastric variceal hemorrhage caused by proximal gastrectomy and splenectomy are effective in improving liver function, correcting hypersplenism and reducing the rate of rebleeding and mortality.