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对1989~1995年成功实施门奇断流术的120例肝硬变门静脉高压症病人进行了追踪调查,85例(70.83%)获得随访。调查发现,食道静脉曲张复发率为100%,术后发生出血20例,出血和曲张程度与术前静脉曲张程度、门静脉压力明显相关;且术前有出血史者术后出血的机会明显增大,而与术前肝功能情况无明显关系。建议对门静脉压>3.60kPa的重度食道静脉曲张病例,尤其有出血史者,作门奇断流术时宜同时作小口径门腔分流术。而对于无出血史的轻度食道静脉曲张病例,门静脉压亦较低,预防性门奇断流术的价值不大,并可能加重食道静脉曲张程度。
A total of 120 patients with cirrhosis with portal hypertension who underwent successful door-gate disconnection in 1989-1995 were followed up, 85 (70.83%) were followed up. The survey found that the recurrence rate of esophageal varices was 100%, 20 cases of postoperative bleeding, bleeding and varicose degrees and preoperative varicose veins, portal pressure was significantly correlated; and preoperative bleeding history of postoperative bleeding significantly increased the chance of , But no significant relationship with preoperative liver function. Proposed portal pressure> 3.60kPa cases of esophageal varices, in particular, have a history of bleeding for the door when the odd flow should also be used for small-caliber portal shunt. For mild cases of esophageal varices without bleeding history, portal pressure is also low, the value of prophylactic door-odd disconnection is not significant, and may increase the degree of esophageal varices.