CAJ | 학술논문

目的探讨改良脾-肺固定术治疗门静脉高压症的疗效.方法观察门静脉高压症患者行改良脾-肺固定术后不同时期白细胞、血小板,血清补体(C3、C4)、淋巴细胞亚群( CD4、CD8)及门静脉系统血流动力学的变化,并与术前作统计学分析.结果改良脾-肺固定术术后6个月白细胞由(3.27±1.93)×109/L上升至(6.70±2.12)×109/L,血小板由(77.60 ±44.14)×109/L上升至( 164.00 ±66.78)×109/L; C3含量由(0.83 ±0.06) g/L上升至(1.03 ±0.15) g/L,C4含量由(0.12 ±0.02) g/L上升至(0.16 ±0.02) g/L,CD4由(25.07±5.35)％上升至(31.18±5.26)％,CD4/CD8由(1.74±0.25)上升至(2.03±0.36)；自由门静脉压由(43.92±5.50) cm H2O(1 cm H2O =0.098 kPa)降至(33.92±5.50) cm H2O,与术前比较差异均有统计学意义(P＜0.05)；术后6个月彩色多普勒超声显示脾-肺间侧支循环形成.结论改良脾-肺固定术治疗门静脉高压症既能纠正脾功能亢进、维持机体免疫功能,又能降低门静脉压力、预防上消化道出血.
목적 탐토개량비-폐고정술치료문정맥고압증적료효.방법 관찰문정맥고압증환자행개량비-폐고정술후불동시기백세포、혈소판,혈청보체(C3、C4)、림파세포아군( CD4、CD8)급문정맥계통혈류동역학적변화,병여술전작통계학분석.결과 개량비-폐고정술술후6개월백세포유(3.27±1.93)×109/L상승지(6.70±2.12)×109/L,혈소판유(77.60 ±44.14)×109/L상승지( 164.00 ±66.78)×109/L; C3함량유(0.83 ±0.06) g/L상승지(1.03 ±0.15) g/L,C4함량유(0.12 ±0.02) g/L상승지(0.16 ±0.02) g/L,CD4유(25.07±5.35)％상승지(31.18±5.26)％,CD4/CD8유(1.74±0.25)상승지(2.03±0.36)；자유문정맥압유(43.92±5.50) cm H2O(1 cm H2O =0.098 kPa)강지(33.92±5.50) cm H2O,여술전비교차이균유통계학의의(P＜0.05)；술후6개월채색다보륵초성현시비-폐간측지순배형성.결론 개량비-폐고정술치료문정맥고압증기능규정비공능항진、유지궤체면역공능,우능강저문정맥압력、예방상소화도출혈.
Objective To evaluate the effect of modified splenopneumopexy treatment for portal hypertension.Methods In the patients with portal hypertension in different periods after modified splenopneumopexy,the changes in leukocytes,platelets,serum complement,lymphocyte subsets and the hemodynamics of portal vein were observed and compared with those preoperation.Results After 6 months,the number of leukocytes was increased from (3.27 ± 1.93 ) × 109/L to (6.70 ± 2.12) × 109/L and that of platelets from (77.60 ± 44.14) × 109/L to ( 164.00 ± 66.78) × 109/L,the level of C3 from (0.83 ±0.06) g/L to ( 1.03 ± 0.15 ) g/L,C4 from (0.12 ± 0.02) g/L to (0.16 ± 0.02) g/L,the level of CD4 from (25.07 ± 5.35 ) ％ to ( 31.18 ± 5.26) ％,CD4/CD8 from ( 1.74 ± 0.25 ) to (2.03 ± 0.36),while the free portal pressure was decreased from (43.92± 5.50) cmH2O (1 cmH2O=0.098 kPa) to (33.92 ± 5.50) cm H2O.There were significant differences statistically in above indexes before and after operation ( P ＜ 0.05 ).Color Doppler ultrasound revealed that formation of the collateral circulation between the spleen and lung 6 months after operation.Conclusion The modified splenopneumopexy for portal hypertension not only can correct hypersplenism and maintain the immunological function,but also lower the pressure of portal vein and prevent hemorrhage of the upper digestive tract.