The Curative Effect Analysis Of Pericardial Devascularization And Modified Sugiura (167 Cases)

Aims:To analyze the clinical data of portal hypertension,include the cases with pericardial devascularization, modified sugiura,summarize the experience and effectiveness of treating portal hypertension,then discuss how to choice the way of operation.Methods:Retrospective analysis of 167 cases,156 cases with selective operation,11cases with emergent operation。Analyzed data included the situation before operation,the complications of postoperation,the recovery results of postoperation.Follow-up the results of the patients with rebleeding and death between 1 to 6 years. Analyze the effectiveness of the differrent species of operation.All data analysis is adopted SPSS 13.0,quantitative data analyzed with T test,categoricaldata analyzed with the chi-square (X2)test,P<0.05 stands for statistical significance.Results:l.The index before operation:compare the history of bleeding,esophagel varices,liver function,the diameter of portal vein between pericardial devascularization and modified sugiura, P>0.05,have not statistical significance.2,Short-term curative effect analysis(between 6 months):The time of taking food and operation between pericardial devascularization and modified sugiura, P< 0.05,have statistical significance. There are the main complications of pericardial devascularization:3 cases with incision infection,1 case with lung infection,0 case with esophageal strictrue,0 case with esophageal fistula,3 cases with pleural effusion, 2 cases with liquid accumulated under the diaphragm,11 cases with spleen heat,1 case with large ascites,3 cases with bleeding in enterocoelia,1 case with upper gastrointestinal bleeding,4 cases with portal vein thrombus,1 case with hepatic encephalopathy. There are the main complications of modified sugiura:3 cases with incision infection,1 case with lung infection,2 cases with esophageal strictrue,1 case with esophageal fistula,5 cases with pleural effusion,6 cases with liquid accumulated under the diaphragm,18 cases with spleen heat,3 case with large amount of ascites,1 case with bleeding in enterocoelia,0 case with upper gastrointestinal bleeding,6 cases with portal vein thrombus,1 case with hepatic encephalopathy.Compared with two teams, P>0.05,have not statistical significance.3.Long-term curative effection(after 6 months):The rebleeding rate of pericardial devascularization is 6.06%, the bleeding rate of modified sugiura is7.50% (6/80).2 cases death of pericardial devascularization and 2 cases death of modified sugiura, Pairwise comparison P>0.05, have no significant differences.Conclusions:Pericardial devascularization and modified sugiura have the same curative effect, but pericardial devascularization is more simple than modified sugiura,and ruduce the risk of esophageal strictrue and fistula,the time of eating of pericardial devascularization is earlier than modified sugiura,and the operation time is shorter, so pericardial devascularization is the first choice.