Evaluation in combination of modified pericardial devascularization with splenorenal shunt for portal hypertension with upper digestive tract hemorrhage

doi:10.3877/cma.j.issn.1647-0793.2013.01.005

Abstract

Abstract:

Objective

To study the effect of modified pericardial devascularization (MPCDV) combined with splenorenal shunt (SRS) for portal hypertension with upper digestive tract hemorrage.

Methods

From September 2005 to May 2010, the clinical and follow-up data of 46 cases with portal hypertension with upper digestive tract hemorrage were collected. The survival analysis was conducted between MPCDV+SRS group (24 cases) and MPCDV group (22 cases) divided by treatment.

Results

There was no difference in baseline clinical data between the two groups. After treatment, the FPP in MPCDV+SRS group (37.1±9.7) cm H₂O was higher than in MPCDV group (30.1±8.9) cm H₂O (P<0.05). The positive rates of portal hypertensive gastropathy (PHG), upper digestive hemorrhage and portal embolism in MPCDV+SRS group were significantly lower than in MPCDV group after operation (P<0.05, respectively). But there was no difference in hepatic encephalopathy between the two groups.

Conclusion

The clinical effect of combination of MPCDV with SRS is better than only MPCDV.

Key words: Hypertension, Portal, Hemorrhage, Devascularization, Splenorenal shunt

Xin-feng LI, Gao-xiong WANG, Tian-cong HUANG, Cheng-zhong LI, Chao-ping YE, Ji CHEN, Ling-yan CHEN. Evaluation in combination of modified pericardial devascularization with splenorenal shunt for portal hypertension with upper digestive tract hemorrhage[J]. Chinese Archives of General Surgery(Electronic Edition), 2013, 07(01): 17-20.

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Figures/Tables 4

References 7

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临床资料		联合组	断流组	t值/ χ²值	P值
例数		24	22	?	?
年龄（岁，±s）^a		48.6±0.32	50.2±0.11	-23.054	>0.05
性别		?	?	0.700	0.403
?	男	18	14	?	?
?	女	6	8	?	?
肝功能		?	?	0.136	0.713
?	A级	14	14	?	?
?	B级	10	8	?	?
出血史（次/例，±s）^a		1.68±0.23	1.59±0.54	0.723	>0.05
门静脉高压胃病		?	?	0.001	0.979
?	无	13	12	?	?
?	有	11	10	?	?
腹水		?	?	1.344	0.246
?	无	15	10	?	?
?	有	9	12	?	?

临床资料		联合组	断流组	t值/ χ²值	P值
例数		24	22	?	?
年龄（岁，±s）^a		48.6±0.32	50.2±0.11	-23.054	>0.05
性别		?	?	0.700	0.403
?	男	18	14	?	?
?	女	6	8	?	?
肝功能		?	?	0.136	0.713
?	A级	14	14	?	?
?	B级	10	8	?	?
出血史（次/例，±s）^a		1.68±0.23	1.59±0.54	0.723	>0.05
门静脉高压胃病		?	?	0.001	0.979
?	无	13	12	?	?
?	有	11	10	?	?
腹水		?	?	1.344	0.246
?	无	15	10	?	?
?	有	9	12	?	?

组别	例数	手术前	手术后	下降值
联合组	24	40.0±5.7	30.1±8.9	8.2±3.8
断流组	22	40.2±5.5	37.1±9.7	1.9±0.2
t值	?	0.121	2.553	2.090
P值	?	0.823	P<0.05	P<0.05

组别	例数	手术前	手术后	下降值
联合组	24	40.0±5.7	30.1±8.9	8.2±3.8
断流组	22	40.2±5.5	37.1±9.7	1.9±0.2
t值	?	0.121	2.553	2.090
P值	?	0.823	P<0.05	P<0.05

组别	例数	肝性脑病	门静脉高压性胃病	上消化道再出血	门静脉系统血栓
联合组	24	2	1	1	1
断流组	22	1	8	6	7
χ²值	?	0.270	7.561	4.750	6.109
P值	?	0.603	0.006	0.029	0.013

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