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[全门体分流术后长期生存的影响因素:多元回归分析]

[Factors in long-term survival after total portal systemic shunting: a multiple regression analysis].

作者信息

Jiang Z M

出版信息

Zhonghua Wai Ke Za Zhi. 1989 Nov;27(11):676-9, 702.

PMID:2632200
Abstract

163 patients with portal hypertension underwent portal systemic shunting at PUMC hospital during the time of 1970's. There were 98 cases had central spleno-renal shunts. 38 had portacaval shunts and 27 had meso-caval shunts. The live function in this group are A-40%, B-55% and C-5%. The totaled operative mortality was 11.0%, and the totaled 5 years survival was 59.5%. The analysis reveals that: (1) The long-term survival and the patient's life quality were significant influenced by liver function and the type of shunting; (2) The mortality of emergency operation was significant higher than elective shunting surgery (30.0% vs 4.6%); (3) The cephalopathy and rebleeding rate were correlated with the type of shunting, liver function and the diameter of shunt; (4) The patient with A or B liver function could accept either elective or emergency operation, but emergency surgery should be carefully chosen for. The mortality was higher than 80% in emergency shunting for the patient with liver function C.

摘要

20世纪70年代,163例门静脉高压患者在协和医院接受了门体分流术。其中98例行脾-肾分流术,38例行门腔分流术,27例行肠系膜-腔静脉分流术。该组患者肝功能分级为A级的占40%,B级的占55%,C级的占5%。手术总死亡率为11.0%,5年总生存率为59.5%。分析结果显示:(1)肝功能和分流类型对长期生存及患者生活质量有显著影响;(2)急诊手术死亡率显著高于择期分流手术(30.0%对4.6%);(3)脑病和再出血率与分流类型、肝功能及分流直径相关;(4)肝功能为A或B级的患者可接受择期或急诊手术,但急诊手术需谨慎选择。肝功能为C级的患者急诊分流术死亡率高于80%。

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