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目的分析晚期血吸虫病门脉高压症术后近期再手术原因,探讨控制再手术率的措施。方法回顾性分析2004年9月至2009年9月湖南省晚期血吸虫病救助期间23例近期再手术病例资料。结果晚期血吸虫病门脉高压症手术589例,近期再手术23例,再手术率为3.9%。其中2次手术16例,3次手术6例,4次手术1例。再手术原因有腹腔大出血、消化道穿孔、胰尾部损伤、粘连性肠梗阻、切口感染、切口裂开、膈下脓肿。所有患者均痊愈出院,随访5～20月均无严重并发症出现。结论晚期血吸虫病术后近期再次手术原因与术前准备不充分,术中操作过失及术后处理不到位有关。加强围术期处理是提高手术质量和疗效、控制再手术率的关键。
Objective To analyze the causes of postoperative short-term reoperation after advanced schistosomiasis and to discuss the measures to control the rate of reoperation. Methods A retrospective analysis of 23 cases of recent reoperation during the rescue of advanced schistosomiasis in Hunan Province from September 2004 to September 2009 was conducted. Results 589 cases of advanced schistosomiasis portal hypertension surgery, the recent reoperation in 23 cases, the reoperation rate was 3.9%. Among them, there were 16 cases of 2 surgeries, 6 cases of 3 surgeries and 1 case of 4 surgeries. Reoperation causes abdominal bleeding, digestive tract perforation, pancreatic tail injury, adhesive intestinal obstruction, incision infection, incision split, subphrenic abscess. All patients were cured and discharged. No serious complications occurred during the follow-up of 5 to 20 months. Conclusion The reasons for the recent reoperation of advanced schistosomiasis are not related to preoperative preparation, intraoperative operative failure and postoperative management. Strengthening perioperative management is to improve the quality and efficacy of surgery, the key to control the rate of reoperation.