生长抑素八肽对门脉高压患者脾切除断流术后腹腔引流量影响.docVIP

生长抑素八肽对门脉高压患者脾切除断流术后腹腔引流量影响 　　[摘要] 目的 研究生长抑素八肽对门脉高压患者脾切除+断流术后腹腔引流量的影响。方法 回顾性分析60例肝硬化、门脉高压并食道静脉曲张患者的临床资料，其中33例行脾切除+断流术后2h使用生长抑素八肽0.1mg/6h，连续3d，另27例未使用生长抑素，记录术后3d血红蛋白丢失量和5d腹腔引流量。结果 全组患者手术后恢复顺利，无死亡发生，但使用生长抑素组腹腔引流量及血红蛋白丢失量明显少于对照组（P＜0.05）。结论 术后早期使用生长抑素能降低门脉压力，显著减少脾切除+断流术后手术创面的渗血及术后腹水的形成。 　　[关键词] 肝硬化；门脉高压；脾切除联合断流术；生长抑素八肽；腹腔引流量 　　[中图分类号] R575.2[文献标识码] B [文章编号] 1673-9701（2011）25-101-02 　　 　　Effect of Somatostatin Octapeptide on Postoperative Abdominal Drainage in Patients with Portal Hypertension after Splenectomy Combined with Devascularization 　　HUANG HaijiangZHENG JunXU Yiping 　　Department of Hepatobiliary Surgery, Zhuji People’s Hospital, Zhuji 311800, China 　　 　　[Abstract] Objective To study effect of somatostatin octapeptide on postoperative abdominal drainage in patients with portal hypertension after splenectomy combined with devascularization. Methods Retrospectively analyzed the clinical data of 60 patients with liver cirrhosis, portal hypertension and esophageal varices, including 33 cases received somatostatin octapeptide at 2 hours after splenectomy combined with devascularization, 0.1mg/6h for 3 days, and the other 27 cases did not receive somatostatin, and recorded the amounts of hemoglobin loss of 3 days and abdominal drainage of 5 days after surgery. Results All patients recovered well after surgery and no deaths occurred. However, abdominal drainge and hemoglobin loss of using somatostatin group were significantly less than the control group (P＜0.05). Conclusion Early using somatostatin can reduce portal hypertension, decrease postoperative abdominal drainge after splenectomy combined with devascularization. 　　[Key words] Liver cirrhosis; Portal hypertension; Splenectomy combined with devascularization; Somatostatin octapeptide; Abdominal drainage 　　 　　肝硬化、门脉高压症在我国十分常见，病因包括肝炎、血吸虫病、酒精性以及持续胆汁郁积等，它所导致的食道胃底静脉曲张破裂出血是肝硬化的主要死亡原因。门脉高压症手术方式大致可分成分流及断流两大类，但仍有较多的问题未解决，如术后极易出现大量腹水、创面出血等，有较高的病死率。2004年1月～2010年10月我科设计对脾切除+断流手术患者术后短期应用生长抑素八肽，预期减少腹腔引流量，缩短患者康复时间