肝移植时代常规手术治疗门静脉高压症作用的探讨.docVIP

肝移植时代常规手术治疗门静脉高压症作用的探讨 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：肝移植时代常规手术治疗门静脉高压症作用的探讨 1 1 资料和方法 2 2 结果 3 3 讨论 4 文2：肝移植时代门静脉高压症外科治疗的评价 6 参考文摘引言： 12 原创性声明（模板） 13 文章致谢（模板） 13 正文 肝移植时代常规手术治疗门静脉高压症作用的探讨 文1：肝移植时代常规手术治疗门静脉高压症作用的探讨 【Abstract】 Objective To compare the role of conventional operation (including shunting and devascularization) and liver traplantation in treatment of posthepatitic portal hyperteion. Methods A retrospective study was carried out for analyzing surgeries performed in 303 cases of posthepatitic portal hyperteion including 239 cases treated with conventional operation (conventional group) and 64 cases treated with liver traplantation (traplantation group) that were followed up for 3-5 yea to observe rehemorrhage and mortality rate. Results Conventional operation was eutherapeutic among Child A and Child B cases but poor in Child C cases. The mortality rate of Child C cases in traplantation group was %, significantly lower than % in conventional group. Conclusio Conventional operation can maintain good postoperative liver function and life quality for cases with hemorrhage history and with liver function at Child A and B. However, for cases with poor liver function that can not attain satisfactory effect by conventional operation, liver traplantation is the only effective curative way to Child C and serious liver function injury patients. 【Key words】 Portal hyperteion; Liver traplantation; Liver function 肝炎后肝硬化门静脉高压症在我国较为常见，70%～80%门静脉高压症是由乙型病毒性肝炎导致的，常出现食管胃底静脉曲张破裂出血，威胁患者生命。常规手术(断流、分流术)只能起到治“标”的作用，而肝移植能达到“标本”兼治的功效。在肝移植时代常规手术(断流、分流术)在门静脉高压症治疗中的价值仍存在争议，本文就肝移植与常规手术在治疗门静脉高压症中的作用进行探讨，现报告如下。 1 资料和方法 一般资料 对我所2000年1月至2005年4月收治的303例肝炎后肝硬化门静脉高压症患者的手术治疗进行回顾性分析。全部患者入院时均有不同程度的门脉高压症表现,如脾肿大、脾功能亢进(外周血白细胞及血小板计数减少等)、食管静脉曲张、上消化道出血。术前行CT、胃镜或上消化道钡餐检查，食管胃底静脉曲张轻、中度167例，重度136例。 143例患者有不同程度的腹水。 303例患者分为常规手术组和肝移植组。常规手术组239例，其中男171例，女68例，年龄33～71岁；Child A级56例(%)，B级103例(%)，C级80例(33.%%)。肝移植组64例，其中男52例，女12例，年龄29～67岁；Child B级21例(%)，C级43例( 治疗方法 常规手术组断流术(193例)手术