门奇断流术后并发胸腔积液12例危险因素分析-中华普通外科学文献.pdfVIP

· 2 9 4 · 中华普通外科学文献（电子版）2014 年 8 月第 8 卷第 4 期 Chin Arch Gen Surg（Electronic Edition），August 2014，Vol.8，No.4 ·论著 · 门奇断流术后并发胸腔积液 12 例危险 因素分析 朱耿隆　陈东　苏永辉　贾英斌　索南仁青　关晓东　洪晓鹏　张百萌 　　 【摘要】　目的　探讨门奇断流术后胸腔积液的危险因素及防治措施 。方法　回顾性分 析 2008 年 3 月至 2012 年 9 月收治的 77 例行门奇断流术患者的临床资料。结果　7 例（7/77， 9.1%）术前有行非选择性脾动脉栓塞。70 例（70/77，90.9%）采用脾切除 + 贲门周围血管离断术式， 7 例（7/77，9.1%）采用改良 Sugiura 术式。平均住院时间为（16.7±2.2）d，住院期间无一例死亡及行 二次手术。门奇断流术后胸腔积液发生 12 例（15.6%）。单因素分析提示门奇断流术后胸腔积液的发 生与术前肝功能、脾脏大小、脾周粘连、手术方式及术前脾动脉栓塞有关，差异有统计学意义（P 0.05）； 多因素 Logistic 回归分析提示手术方式、术前脾动脉栓塞是影响胸腔积液发生的独立因素（P 0.05）。 结论　通过避免术前脾动脉栓塞、选择适当的手术方式并改进手术操作，可有效减少门奇断流术后 胸腔积液的发生 。 　　 【关键词】　门奇断流术；Sugiura 术；胸腔积液 Risk factors for pleural effusion after pericardial devascularization: clinical analysis of 12 cases Zhu Genglong*, Chen Dong, Su Yonghui, Jia Yingbin, Suo Nanrenqing, Guan Xiaodong, Hong Xiaopeng, Zhang Baimeng. *The Third Department of General Surgery, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China Corresponding author: Zhang Baimeng, Email: bmzhang411@163.com 　　【Abstract】　Objective　To investigate the risk factors for pleural effusion and the corresponding prophylactico-therapeutic measures after pericardial devascularization in patients with portal hypertension. Methods　Seventy-seven cases with portal hypertension after hepatitis undergoing pericardial devascularization in the Third Department of General Surgery in the Fifth Affiliated Hospital of Sun Yat- sen University from Mar 2008 to Sep 2012 were selected for a retrospective study. Results　In these 77 patients, 7 cases(9.1%) accepted nonselective splenic embolism before operation. The types of operation were divided into two groups, 70 cases(90.9%) accepted splenectomy plus pericardial devascularization without esophageal transection, the other 7 cases(9.1%) were given modified Sugiura oper