Objective To analyze the effects of selective and nonselective pericardial devascular-ization( PD )on portal hypertension and upper gastrointestinal hemorrhage and investigate an effective cure for portal hypertension. Methods The clinical data of 86 patients with portal hypertension and upper gastrointestinal hemorrhage were retrospectively reviewed, including the selective and nonselective groups according to the procedures. Preoperative and postoperative clinical efficacy indexes, including free portal pressure( FPP ), change of gastric and esophageal varices, rates of rebleeding and ascites were compared and analyzed. Results After laparotomy and splenectomy, the difference between the groups in FPP was not significant( P >0. 05 ). In both groups,the postoperative FPP was significantly reduced compared with the preoperative one( P <0. 01 ). The difference of postoperative FPP between the groups was significant (P<0. 01 ). Compare with the selective group, the ratios of rebleeding and ascites in the nonselective group were significantly higher( P < 0.05 ). Conclusion Compared with the nonselective PD, selective PD is a better choice for portal hypertension with upper gastrointestinal hemorrhage.%目的 分析门静脉高压症非选择性贲门周围血管离断术和选择性贲门周围血管离断术的疗效,探讨治疗门静脉高压症的合理手术方式.方法 回顾性分析86例门静脉高压症并上消化道出血患者的临床资料,并根据手术方式将患者分为非选择性断流组和选择性断流组,对两组患者手术前、后门静脉压(FPP),食管胃底静脉曲张程度的变化,术后再出血率及腹水消失率等临床疗效进行比较分析.结果 两组开腹后和切脾后FPP差异无统计学意义(P＞0.05),非选择性断流组术后FPP下降和术前相比差异有统计学意义(P＜0.05),选择性断流组术后FPP下降和术前相比差异有统计学意义(P＜0.01),两组间术后FPP下降差异也有统计学意义(P＜0.01).术后再出血率和腹水未消失率非选择性断流组均高于选择性断流组,差异有统计学意义(P＜0.05).结论 选择性断流术与非选择性断流术相比较,前者临床效果更佳,是门静脉高压症并上消化道出血患者较理想的术式.
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