目的 探讨国产吻合器在门静脉高压症行脾切除、门奇断流术中的应用及疗效分析.方法 选择2002年1月至2008年1月于我院拟行手术治疗的肝硬化门静脉高压症患者189例,分为观察组102例和对照组87例.对照组行单纯脾切除加门奇断流术,观察组在对照组基础上应用吻合器行食管下段部分切除再吻合术.比较两组患者在手术时间、住院时间、围手术期并发症发生率、食管和胃底静脉转归、再出血发生率和生存率等方面的差异.结果 观察组的手术时间和住院时间均明显短于对照组(P＜0.05).术后6个月后经复查纤维胃镜或上消化道钡餐显示,观察组食管胃底静脉曲张消失率明显高于对照组(P＜0.05).随访3年,观察组患者1、2、3年累计再出血发生率明显低于对照组,而1、2、3年累计生存率则明显高于对照组(P＜0.05).结论 应用国产吻合器操作简单、安全有效,能提高贲门周围血管离断术的彻底性,临床疗效显著.%ObjectiveTo explore the application and efficacy of domestic staples in splenectomy and portoazygous devascularization. Methods From January 2002 to January 2008,102 protal hypertension patients were treated with portoazygos vein devascularization plus partial resection of the lower part of the esophagus with staple(study group)and the other 87 patients received portoazygos vein devascularization alone(control group). The duration of surgery, length of hospital stay, rate of perioperative compactions, outcomes of esophagogastric varices, rate of postoperative rebleeding, and survival rate were observed. Results The duration of surgery and length of hospital stay were shorter in the study group than in the control group(P＜0.05). The disappearance rate of esophagogastric varices was higher in the study group than in the control group 6 months after surgery(P＜ 0.05). All the patients were followed up for 3 years. The 1, 2, 3, 4, 5 year cumulative rebleeding rates in the observed group were higher than those in the control group(P＜ 0.05). 1, 2, 3year cumulative rebleeding rates were lower in the study group than in the control group while 1, 2, 3year cumulative survival rates were higher(P ＜ 0.05). Conclusions Domestic staples are simple, safe and effecive in splenectomy and portoazygos devascularization
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