Effects Of Different Portal-odd Devascularization Procedures On Liver Function In Patients With Portal Hypertension

Objective: to investigate the effect of selective and non-selective strangeness gate devascularization on postoperative liver function in patients with portal hypertension.Methods:A retrospective analysis was performed on the clinical data of patients diagnosed with cirrhosis of the liver with hypersplenism and esophageal varicose veins admitted to YIJISHAN hospital of WANNAN medical college from June 2015 to June2018.Among them,25 cases(experimental group)and 20 cases(control group)were treated with selective gate disconnection.Record the following indicators: gender,age,height,weight,BMI,operation time,intraoperative blood loss,postoperative anal exhaust time,spleen nest drainage tube decannulation time,postoperative hospitalization days,postoperative complications,such as abdominal cavity hemorrhage,ascites,hepatic encephalopathy,portal vein thrombosis,etc.),preoperative and postoperative 1,3,5 days of routine blood,blood clotting,liver and kidney function,electrolyte and preoperative ICGR15 day and 1 week.Results:Both groups successfully completed the operation,in which 3 patients were transferred to laparotomy,and no patients died after the operation.Blood routine indexes:WBC indexes of the two groups increased significantly after surgery compared with before surgery,with statistically significant difference(P<0.05),but no statistically significant difference between the two groups(P>0.05).WBC began to decline on the third day after surgery,and the difference was statistically significant compared with thefirst day before surgery(P<0.05).Postoperative HGB was higher than that before the operation,and the difference was not statistically significant(P>0.05).There was no significant difference between the two groups(P>0.05).PLT indexes of the two groups increased significantly after surgery compared with before surgery,and the difference was statistically significant(P<0.05),while the comparison between the two groups was not statistically significant(P>0.05).Liver function indexes: the postoperative ALB indexes of the two groups were slightly lower than those before the operation,and the difference was not statistically significant(P>0.05);the comparison between the two groups was not statistically significant(P>0.05);the fifth day after the operation was slightly higher than that on the first day and the third day,and the difference was not statistically significant(P>0.05);the comparison between the two groups was not statistically significant(P>0.05).TBIL in the experimental group decreased after surgery compared with before surgery,and the difference was not statistically significant(P>0.05).In the control group,TBIL increased significantly on the first day after surgery,and decreased on the third day and the fifth day.The difference was statistically significant(P<0.05),and the comparison between groups was statistically significant(P<0.05).There was no significant difference between the two groups(P>0.05),and there was no significant difference between the two groups(P>0.05).The indexes of ALT and AST in the two groups increased postoperatively and decreased on the third and fifth day(P<0.05).There was no significant difference between the two groups(P>0.05).The PT index of the two groups increased on the first day after surgery compared with that before surgery,and decreased on the third day and the fifth day,the difference was not statistically significant(P>0.05).ICG test index: ICGR15 index of the experimental group increased after surgery compared with before surgery,and the difference was statistically significant(P<0.05).The difference of postoperative EHBF reduction was statistically significant(P<0.05).ICGR15 in the control group increased after surgery compared with before surgery,and the difference was not statisticallysignificant(P>0.05).There was no significant difference in the reduction of EHBF after surgery compared with that before surgery(P>0.05).The difference between the two groups was statistically significant(P<0.05).Postoperative complications: among the 25 cases in the experimental group,1 cases had portal vein thrombosis.The overall incidence of complications was 4%.Among the 20 cases in the control group,5 cases had postoperative complications of ascites and 4 cases had portal vein thrombosis.The overall complication rate was 45%.No deaths occurred in the two groups during the operation,and the difference between the two groups was statistically significant(P<0.05).Conclusion:1.The overall curative effect of selective gate odd devascularization in the treatment of portal hypertension is higher than that of non-selective gate odd devascularization,which is worthy of clinical promotion and application.2.The short-term effect of non-selective portal odd devascularization on hepatic metabolism in patients with portal hypertension is less than that of selective portal odd devascularization.