摘要
目的探讨外科手术在门脉高压症上消化道大出血患者治疗中的价值以及手术时机的选择。方法对太和医院收治的186例患者的临床资料进行回顾性分析。结果130例患者保守治疗出血停止后行择期手术,保守治疗无效行急诊手术28例,另外28例未行手术治疗。未行手术、急诊手术、择期手术组的死亡率分别为:57.1%(16/28),17.9%(5/28)和2.3%(3/130),P<0.05;择期手术与急诊手术组的并发症分别为17.3%(4/23)和3.9%(5/127)P<0.05。择期手术组出血次数愈多,术前准备时间和术后恢复时间越长,肝功能恢复越差,需要输血量越多。结论肝硬化门静脉高压症上消化道大出血短期非手术止血效果欠佳时,应尽早急诊手术;对于出血停止的患者,也需尽早手术治疗。
Objective To explore the value and the best operation time for the variceal bleeding of portal hypertension of cirrhotic patients. Method The clinical data of 186 patients of cirrhotic portal hypertension vafieeal bleeding admitted to the Taihe hospital in the latest three years analyzed retrospectively. Results 130 patients received elective operation after the bleeding stopped by conservative therapy and 28 patients received salvage surgery because the non-operation of short-term could not hemostasia effectively, the others 28 patients did not received operation. The mortality of non - operation, selective and salvage surgery were 57. 1% （ 16/28 ） , 17.9% （5/28） and 32. 3% （3/130） （both P 〈0.05） ,and the complication rate of selective and salvage surgery were 14. 3% （4/28） and 3.8% （5/130） （P 〈0.05）. For the selective surgery group; the more of the bleeding time, and the longer of the fore-operation and post-operation tim ; while the liver function was worse, and the blood transplanted was more. Conclusion For the patients of portal hypertension variceal bleeding of cirrhosis, the salvage surgery should be done as early as possible if bleeding could not be stopped in a short time, and the selective surgery should also be done early after the bleeding stopped by conservative therapy.
出处
《肝胆外科杂志》
2008年第4期269-271,共3页
Journal of Hepatobiliary Surgery
