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肝硬变时手术的死亡率和术后合并症明显增加,伴发急腹症时,急诊手术的危险性更大.本文总结我院1989～1995年经手术治疗的肝硬变合并急腹症35例探讨手术治疗的危险因素及其对策.1.临床资料1.一般资料 35例中,急性坏疽性胆囊炎12例:溃疡病急性穿孔18例;外伤性脾破裂5例.年龄42～67岁.确诊肝硬变病史最短1年8个月,最长5年3个月.临床表现:食管下静脉曲张破裂出血4例、肝掌、蜘蛛痣6例、腹水5例、脾肿大28例、肝缩小15例、黄疸5例、前腹壁静脉曲张2例、术中见门静脉系统扩张18例.Chlid分级:A级30例;B、C级5例.
Surgical mortality and postoperative complications of liver cirrhosis increased significantly, with acute abdomen, the greater the risk of emergency surgery.This article summarizes our hospital from 1989 to 1995 cirrhosis with acute abdomen 35 Cases of surgical treatment of risk factors and countermeasures 1. Clinical data 1. General Information 35 cases of acute gangrenous cholecystitis in 12 cases: 18 cases of acute ulcer disease perforation; traumatic rupture of the spleen in 5 patients aged 42 to 67 years Diagnosis of cirrhosis of the shortest history of 1 year and 8 months, up to 5 years and 3 months. Clinical manifestations: bleeding in 4 cases of esophageal varices, liver palms, spider nevus in 6 cases, ascites in 5 cases, splenomegaly in 28 cases , Liver shrunk in 15 cases, jaundice in 5 cases, anterior abdominal varicose vein in 2 cases, intraoperative portal vein system expansion in 18 cases .Chlid classification: A grade in 30 cases; B, C grade in 5 cases.