Comparative Analysis Of Clinical Efficacy Between The Combined Devascularization And The Pericardial Devascularization In The Treatment Of Portal Hypertension Caused By Cirrhosis

Objective: To choose the better operation and summarize the clinical experiences by comparing the operational efficacy and patients’ postoperative clinical characteristics of the combined devascularization and the pericardial devascularization in the treatment of portal hypertension caused by cirrhosis.Methods: We retrospectively analyzed the clinical data of 160 patients who were treated with the combined devascularization or the pericardial devascularization from the January 1996 to the December 2012 in The First Affiliated Hospital of Dalian Medical University and The Second Affiliated Hospital of Dalian Medical University.According to the different operation methods, these patients were divided into the pericardial devascularization group(control group) and the combined devascularization group(observe group). Each group contains 80 cases. The observed parameters included the operation time, the fasting time, emergency stop bleeding rates, the incidence of postoperative complication in one month, the elimination ratio of EGV in one month, the upper gastrointestinal hemorrhage rate and the mortality rate within two years. SPSS17.0 statistical software was used to analysis the data. The measurement data was analyzed by T-test and expressed by x ±s. The count data was expressed by rate or constituent ratio and analyzed by chi-square(X2) test. P < 0.05 indicates the difference is significant.Results: The preoperative parameters between the observe group and the control group,including gender, age, etiology, bleeding history, operation opportunity, white blood cell count(WBC), platelet count(PLT), hemoglobin(HGB), the portal vein width,Child-Pugh classification, esophageal varices degree, have not statistical difference(P>0.05). In the observe group, operation time was 232.08±64.24 min, fasting time was5.38±1.36 d, one-month EGV disappearance rate was 90%, two-year upper gastrointestinal hemorrhage rate was 3.4%. In the control group, operation time was211.38±59.36 min, fasting time was 4.56±1.33 d, one-month EVG disappearance rate was 72%, two-year upper gastrointestinal hemorrhage rate was 15%. These intraoperative and postoperative parameters between the two groups were statistically significant(P<0.05) and other parameters had not statistical difference(P>0.05). The operation time and fasting time of the observe group were longer than the control group,the one-month EGV disappearance rate of the observe group was higher than the control group, The two-year upper gastrointestinal hemorrhage rate of the observe group was lower than the control group.Conclusion:1.Both the combined devascularization and the pericardial devascularization have therapeutic effects on the portal hypertension after cirrhosis.2. Because pericardial devascularization has shorter operation time and faster recovery time, it is suitable for emergency operation.3.The combined devascularization has higher one-month EGV disappearance rate and lower two-year upper gastrointestinal hemorrhage rate. Its curative effects is better, so it is suitable for selective operation.