Liu Bo, Lin Nan, Xu Rui-Yun
Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha 410011, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2004 Feb;29(1):87-9.
To investigate the therapeutic effect of endoscopic variceal ligation (EVL) combined with splenectomy on patients with portal hypertension.
The eliminating rate of varicose veins and recurrent bleeding rate were evaluated. Fifty-one paitents with cirrhosis of liver and portal hypertension were randomly divided into 2 groups. We treated 25 portal hypertensive patients using splenectomoy plus EVL. The therapeutic effect of pericardial devascularization in 26 patients with upper gastrointestinal bleeding due to portal hypertension served as the control.
All patients were followed up for 12 months. There was no death due to the operation. All patients in the study group had no upper gastrointestinal rebleeding during the 12-month follow-up. The rebleeding rate in the control group was 11.5% (3/26). The varicose venis eliminating rate was 96% (24/25) in the study group and 50% (13/26) in the control group (P < 0.01). It showed no effect on portal hypertensive gastropathy in the study group, and pericardial devascularization procedure exacerbated the portal hypertensive gastropathy. The thrombosis rate in the portal vein after the operation was 8% (2/25) in the study group and 34.6% (9/26) in the control group (P < 0.05).
EVL combined with splenectomy has less trauma, fewer postoperative complications and high eradication of esophageal varices. It can be used safely in treating portal hypertension.
探讨内镜下静脉曲张套扎术（EVL）联合脾切除术治疗门静脉高压症患者的疗效。
评估静脉曲张消除率和再出血率。将51例肝硬化门静脉高压症患者随机分为2组。对25例门静脉高压症患者采用脾切除术加EVL治疗。将26例门静脉高压症致上消化道出血患者行贲门周围血管离断术的治疗效果作为对照。
所有患者随访12个月。无手术死亡病例。研究组所有患者在12个月随访期间无再次上消化道出血。对照组再出血率为11.5%（3/26）。研究组静脉曲张消除率为96%（24/25），对照组为50%（13/26）（P<0.01）。研究组对门静脉高压性胃病无影响，贲门周围血管离断术加重了门静脉高压性胃病。研究组术后门静脉血栓形成率为8%（2/25），对照组为34.6%（9/26）（P<0.05）。
EVL联合脾切除术创伤小、术后并发症少、食管静脉曲张根除率高。可安全用于治疗门静脉高压症。
