Szczepanik A B, Rudowski W J
Department of Surgery, Research Institute of Haematology, Warsaw, Poland.
Ann R Coll Surg Engl. 1989 Jul;71(4):222-5.
Long-term results of surgical treatment were analysed in 42 patients with extrahepatic portal hypertension treated in the Department of Surgery, Institute of Haematology in Warsaw in the period 1971-1987. In all, 71 operations were carried out, and 20 patients were treated by endoscopic sclerotherapy of oesophageal varices. Recurrence of haemorrhage was found in 6 out of 11 patients 54% after venous shunting, in 13 out of 17 patients (76%) after treatment by ligation of oesophageal varices and in 32 out of 35 patients (91%) after splenectomy. Following repeated sclerotherapy of oesophageal varices, recurrence of haemorrhage occurred in 3 out of 20 patients (15%). During 17 years four deaths occurred (10%) none of which was due to haemorrhage from oesophageal varices. The authors conclude that the method of repeated sclerotherapy is presently the most effective way of preventing haemorrhage from oesophageal varices and consider this form of management as the treatment of choice in patients with extrahepatic portal hypertension.
对1971年至1987年期间在华沙血液学研究所外科接受治疗的42例肝外门静脉高压症患者的手术治疗长期结果进行了分析。总共进行了71例手术，20例患者接受了食管静脉曲张内镜硬化治疗。分流术后11例患者中有6例（54%）出现出血复发，食管静脉曲张结扎治疗后17例患者中有13例（76%）出现出血复发，脾切除术后35例患者中有32例（91%）出现出血复发。食管静脉曲张反复硬化治疗后，20例患者中有3例（15%）出现出血复发。在17年中发生了4例死亡（10%），均非食管静脉曲张出血所致。作者得出结论，反复硬化治疗方法目前是预防食管静脉曲张出血的最有效方法，并认为这种治疗方式是肝外门静脉高压症患者的首选治疗方法。
