[经颈静脉肝内门体分流术（TIPS）、改良的苏吉乌拉手术以及TIPS联合改良的苏吉乌拉手术治疗门静脉高压症的比较]

[Comparison of TIPS, a modified Sugiura procedure and TIPS plus a modified Sugiura procedure for portal hypertension].

作者信息

Wu X, Cao J, Wu X, Han J, Li J

机构信息

Department of Surgery, General Hospital of Nanjing Command, Chinese People's Liberotion Army, Nanjing 210002, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2000 Feb;38(2):98-100.

PMID:11831998

Abstract

OBJECTIVE

Transjugular intrahepatic portosystemic shunts (TIPS), a modified Sugiura procedure and TIPS plus a modified Sugiura procedure were compared to evaluate their clinical results in treatment of portal hypertension.

METHODS

Ninety patients with portal hypertension respectively underwen TIPS (group I, n = 30), a modified Sugiura procedure (group II, n = 30) and TIPS plus a modified Sugiura procedure (group III, n = 30). The rates of rebleeding and encephalopathy, and the mortality of patients with portal hypertension were observed.

RESULTS

The early postoperative complications were observed in 23.33% of the patients in group I, in 30.0% of those in group II, and in 20.0% of those in group III. The early postoperative rates of rebleeding were 6.67% in group I, 10% in group II, and 0% in group III. Hepatic encephalopathy was seen in 16.67% of the patients in group I, 0% in group II and 13.33% in group III. The early mortality was 3.33% in group I. During follow-up for 1 - 36 months, the rates of rebleeding were 34.48% in group I, 33.33% in group II, and 3.33% in group III. The rates of encephalopathy and mortality were respectively 17.20% and 20.69% in group I, 3.33% and 13.33% in group II, 3.33% and 3.33% in group III. The shunt patency in group III was higher than that in group I.

CONCLUSION

Combination of TIPS and a modified Sugiura procedure can be effective to prevent and treat variceal bleeding.

摘要

目的

比较经颈静脉肝内门体分流术（TIPS）、改良Sugiura手术以及TIPS联合改良Sugiura手术治疗门静脉高压症的临床效果。

方法

90例门静脉高压症患者分别接受TIPS治疗（Ⅰ组，n = 30）、改良Sugiura手术（Ⅱ组，n = 30）以及TIPS联合改良Sugiura手术（Ⅲ组，n = 30）。观察门静脉高压症患者的再出血率、肝性脑病发生率及死亡率。

结果

Ⅰ组患者术后早期并发症发生率为23.33%，Ⅱ组为30.0%，Ⅲ组为20.0%。Ⅰ组术后早期再出血率为6.67%，Ⅱ组为10%，Ⅲ组为0%。Ⅰ组患者肝性脑病发生率为16.67%，Ⅱ组为0%，Ⅲ组为13.33%。Ⅰ组早期死亡率为3.33%。随访1 - 36个月，Ⅰ组再出血率为34.48%，Ⅱ组为33.33%，Ⅲ组为3.33%。Ⅰ组肝性脑病发生率及死亡率分别为17.20%和20.69%，Ⅱ组分别为3.33%和13.33%，Ⅲ组分别为3.33%和3.33%。Ⅲ组分流道通畅率高于Ⅰ组。