目的探讨改良Sugiura手术联合保留迷走神经干治疗门静脉高压的效果.方法对肝硬化门静脉高压症患者采用改良Sugiura手术联合保留迷走神经干治疗20例(试验组)与同期行脾切除加贲门周围血管离断术20例(对照组)在肛门恢复排气、排便时间,食管胃底静脉曲张消失情况,自由门静脉压力,术后再出血率及其他并发症等方面作比较.结果患者均获随访,与对照组比较,试验组胃肠排气恢复快[(50±5)h比(72±14)h],食管胃底静脉曲张消失明显[80%(16/20)比40%(8/20)](均P<0.01),两组术后自由门静脉压力均较术前降低,两组比较差异无统计学意义,两组术后短期内均无再出血,远期出血率试验组明显低于对照组[5%(1/20)比30%(6/20),P<0.05].结论改良Sugiura手术联合保留迷走神经干治疗门静脉高压胃肠功能恢复快,远期止血率高,并发症少,是治疗门静脉高压的合理、有效的手术方式.% Objective To discuss the effect ofimproved Sugiura operation combined with preservation of the vagus nerve in treatment of portal hypertension.Methods In patients with liver cirrhosis and portal hypertension improved Sugiura operation combined with preservation of the vagus nerve were used for treatment of 20 patients(experimental group) and concomitant splenectomy plus pericardial devascularization in 20 patients (control group) in anal recovery exhaust, defecation time, esophageal and gastric varices disappeared, free portal pressure, after operation rate of bleeding and other complications were compared.Results The patients were followed up, gastrointestinal exhaust recovery in experimental group were significantly faster [(50±5)h vs(72±14)h] (P<0.01) ,in experimental group esophageal and gastric varices disappeared significantly[80%(16/20) vs 40%(8/20)] (P<0.01), the two groups after the free portal pressure was decreased, the difference was not statistically significant, the two groups shortly after all no rebleeding, long term hemorrhage rate in experimental group was significantly lower than that in control group [5%(1/20) vs 30%(6/20),P<0.05].Conclusion Improved Sugiura operation combined with preservation of the vagus nerve for treatment of portal hypertension and quick recovery of gastrointestinal function, long-term high hemostatic rate, fewer complications, is the treatment of portal hypertension is reasonable, effective operation mode.
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