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Management of upper gastrointestinal bleeding from portal hypertension: Elective or emergency operation?

机译:门静脉高压引起的上消化道出血的处理:择期手术还是急诊手术?

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摘要

>Objective: To evaluate the clinical outcome of emergency and elective operation of splenectomy with periesophagogastric devascularization in treating upper gastrointestinal hemorrhage resulted from portal hypertension. >Methods: We retrospectively reviewed 219 patients of upper gastrointestinal hemorrhage resulted from portal hypertension treated using emergency or elective operation between Jul 2002 and Aug 2010. The clinical data were collected and analyzed. >Results: In the group of elective operation, four patients with grade B and three with grade C died, and in the group of emergency operation, two patients with Grade B and four with Grade C died. The Grade C patients treated using emergency operation presented with a higher mortality than those treated using elective operation, but no significant difference was found (p>0.05). In the two groups, no patients with Grade A died. 17 cases (11.1%) suffered from complications in the group of elective operation and 11 cases (16.7 %) in emergency operation (p>0.05). The complication rate in patients with Grade C is significantly higher than that in patients with Grade A or B in each group (p<0.05). The hospital stay and cost in group of elective operation are significantly higher than those in group of emergency operation (p<0.05). >Conclusion: The patients with Grade A or B treated using emergency operation have similar clinical outcomes as those treated using elective operation, but emergency operation may result in higher rate of death and complication in patients with Grade C.
机译:>目的:评估脾切除术并伴有食管胃食管反血管化的急诊和择期手术治疗门静脉高压引起的上消化道出血的临床效果。 >方法:我们回顾性分析了2002年7月至2010年8月间采用急诊或择期手术治疗的219例门静脉高压导致的上消化道出血的临床资料。 >结果:在择期手术组中,有4例B级患者和3例C级患者死亡,在紧急手术组中,有2例B级患者和4例C级患者死亡。急诊手术治疗的C级患者的死亡率高于择期手术治疗的患者,但差异无统计学意义(p> 0.05)。在这两组中,没有A级患者死亡。择期手术组发生并发症17例(11.1%),急诊手术组11例(16.7%)(p> 0.05)。每组中C级患者的并发症发生率显着高于A级或B级患者(p <0.05)。择期手术组的住院时间和费用明显高于急诊手术组(p <0.05)。 >结论:使用紧急手术治疗的A级或B级患者的临床结局与使用择期手术治疗的患者相似,但紧急手术可能导致C级患者更高的死亡率和并发症。

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