论文部分内容阅读
目的评估食管下段梯状环形缝扎黏膜下血管及胃底折叠术对晚期血吸虫病(晚血)门脉高压症并发上消化道出血的治疗效果。方法 2006-2011年选择患晚血门脉高压症患者,随机分为联合手术治疗组(联合组)与单纯手术治疗组(单纯组)。单纯组患者行门奇静脉断流术,联合组在此基础上加行食管下段梯状环形缝扎黏膜下血管及胃底折叠术。术后通过胃镜检查随访,比较2种术式的治疗效果。结果共选择晚血患者158例,联合治疗组75例,单纯治疗组83例。术后两组治疗有效率分别为81.3%(61/75)和30.1%(25/83)(χ2=39.44,P<0.01),发生再出血率分别为2.7%(2/75)和12.0%(10/83)(χ2=24.36,P<0.01),两组差异有统计学意义。结论食管下段梯状环形缝扎黏膜下血管及胃底折叠术对预防术后再出血效果明显,且术式安全,可作为治疗晚血门脉高压症的常规手术方式。
Objective To evaluate the therapeutic effect of the lower esophageal ring-shaped annular suture submucosal vessels and fundoplication on patients with advanced schistosomiasis (late blood) and portal hypertension complicated by upper gastrointestinal bleeding. Methods From 2006 to 2011, patients with late portal hypertension were randomly divided into two groups: the combined surgery group and the simple surgery group. Patients in the simple group underwent azygous arterial disconnection. On the basis of this, the combined group was given subcutaneous esophageal submandibular ring sutured submucosal vessels and fundoplication. Follow-up by gastroscopy after surgery, the treatment of two kinds of surgical effects. Results A total of 158 patients with late blood were selected, 75 patients in combination therapy group and 83 patients in simple therapy group. The effective rates of the two groups were 81.3% (61/75) and 30.1% (25/83) respectively (χ2 = 39.44, P <0.01), and the rates of rebleeding were 2.7% (2/75) and 12.0% (10/83) (χ2 = 24.36, P <0.01), the difference between the two groups was statistically significant. Conclusion The lower esophageal ring-shaped suture submucosal vascular fundoplication and fundoplication on the prevention of postoperative hemorrhage is obvious, and surgical safety, can be used as a routine surgical treatment of late portal hypertension.