肝硬化门静脉高压症合并胆囊结石外科治疗的临床探析.pdfVIP

摘 要 肝硬化门静脉高压症合并胆囊结石外科治疗的临床分析 研究生：杨炜琦 导师：赵晋明教授 摘 要 目的：探讨肝硬化门静脉高压症合并胆囊结石患者在脾切除加贲门周围血管离 断术中同期切除胆囊的可行性。方法：回顾性分析2002 年1 月至2009 年7 月新疆 医科大学第一附属医院普外科 44 例肝硬化门静脉高压症合并胆囊结石患者临床资 料。结果：同期手术 （CS ）：行脾切除+贲门周围血管离断术，同时行胆囊切除术 25 例，对照组 （SS ）：仅行脾切除+贲门周围血管离断术19 例。肝硬化门静脉高压 症合并胆囊结石患者同期手术与对照组相比较术中出血量、平均住院天数、术后并 发症发生率和死亡率等方面差异无显著意义 （P ＞0.05 ），其中Child-Pugh 分级C 级 患者并发症发生率明显高于A、B 级患者，为80% （4/5 ）。结论：对于肝功能为A、 B 级，肝硬化门静脉高压症合并胆囊结石患者行脾切除加贲门周围血管离断术的同 时行一期胆囊切除是安全可行的，且手术适应症和手术预后都与 Child-Pugh 分级相 关。 关键词：肝硬化； 门静脉高压症； 胆囊结石； 肝功能分级； —1— 新疆医科大学医学硕士学位论文 Clinical analysis on Surgical treatment of cholecystoli- thiasis combined liver cirrhosis with portal hypertension Postgraduate: Yang Weiqi Supervisor: Prof. Zhao Jinmin Abstract Objective: To investigate liver cirrhosis with portal hypertension in patients with gallbladder stones to practice splenctomy and cardia broken away from the peripheral vascular surgery the feasibility of cho lecystectomy in the same period. Methods:A retrospective analysis of 44 cases of liver cirrhosis with portal hypertension clinical data of patients with gallstones o f the first affiliated hospital of Xinjiang medical university between January 2002 and July 2009, Result: The same period in surgery(CS) :splenctomy and cardia broken away from the peripheral vascular surgery, and cholecystectomy had 25 patients. In the control group (SS)：only splenectomy and cardia broken away from the peripheral vascular surgery had 19 patients. Cirrhosis with portal hypertension combined gall stone surgery over the sam