CAJ | 학술논문

目的分析、对比脾栓术后综合征使用糖皮质激素或解热镇痛药的临床效果。方法选择肝硬化合并脾功能亢进术后出现脾栓术后综合征的患者共60例，所有患者均采用Seldinger技术进行部分脾动脉栓塞术。观察组30例患者术后应用地塞米松静脉注射，对照组患者口服非甾体类解热镇痛药。脾栓术后7d观察外周血白细胞、肝功能、血白蛋白。同时还观察发热时间、腹痛时间、住院天数及是否出现上消化道出血、脾脓肿等并发症。结果观察组患者发热时间3.36±2.31 d，疼痛时间7.39±4.00 d，住院天数11.48±3.29 d，对照组发热时间5.72±3.83 d，疼痛时间9.59±4.22 d，住院天数15.07±7.93 d，观察组明显好于对照组（P<0.05）。脾栓术后7天，两组患者白细胞均较术前升高，观察组由（4.23±5.09）×109/L升至（8.49±3.53）×109/L（P<0.05），对照组由（3.21±1.33）×109/L升至（6.52±2.37）×109/L（P<0.05），但观察组术后白细胞较对照组术后白细胞升高更明显（P<0.05）。在肝功能方面（胆红素、谷丙转氨酶、谷草转氨酶、血清白蛋白）两组术前术后均无明显变化。两组均未出现上消化道出血和脾脓肿的并发症。结论脾栓术后综合征静脉应用糖皮质激素效果优于口服解热镇痛药。
목적분석、대비비전술후종합정사용당피질격소혹해열진통약적림상효과。방법선택간경화합병비공능항진술후출현비전술후종합정적환자공60례，소유환자균채용Seldinger기술진행부분비동맥전새술。관찰조30례환자술후응용지새미송정맥주사，대조조환자구복비치체류해열진통약。비전술후7d관찰외주혈백세포、간공능、혈백단백。동시환관찰발열시간、복통시간、주원천수급시부출현상소화도출혈、비농종등병발증。결과관찰조환자발열시간3.36±2.31 d，동통시간7.39±4.00 d，주원천수11.48±3.29 d，대조조발열시간5.72±3.83 d，동통시간9.59±4.22 d，주원천수15.07±7.93 d，관찰조명현호우대조조（P<0.05）。비전술후7천，량조환자백세포균교술전승고，관찰조유（4.23±5.09）×109/L승지（8.49±3.53）×109/L（P<0.05），대조조유（3.21±1.33）×109/L승지（6.52±2.37）×109/L（P<0.05），단관찰조술후백세포교대조조술후백세포승고경명현（P<0.05）。재간공능방면（담홍소、곡병전안매、곡초전안매、혈청백단백）량조술전술후균무명현변화。량조균미출현상소화도출혈화비농종적병발증。결론비전술후종합정정맥응용당피질격소효과우우구복해열진통약。
Objective To compare the clinical effect of glucocorticoids and NSAID in the treatment of partial splenic embolization syndrome. Methods Sixty patients with cirrhosis and spleen hyperactivity who developed partial splenic embolization syndrome after partial splenic embolization with Seldinger technique were randomized equally into two groups to receive treatments with intravenous dexamethasone or oral nonsteroidal anti-inflammatory drugs (NSAIDs). White blood cell counts, liver functions, fever duration, abdominal pain duration, hospital stay, and occurrence of upper gastrointestinal hemorrhage and spleen abscess were recorded and analyzed. Results In dexamethasone group, the average fever duration, abdominal pain duration, and hospitalization days was 3.36 ± 2.31, 7.39 ± 4.00, and 11.48 ± 3.29 days, respectively, significantly shorter than those in NSAIDs group (5.72 ± 3.83, 9.59 ± 4.22, and 15.07 ± 7.93 days, respectively, P<0.05). Seven days after the operation, white blood cell count (×109/L) significantly increased from 4.23±5.09 to 8.49±3.53 in dexamethasone group (P<0.05), and from 3.21±1.33 to 6.52±2.37 in NSAIDs group (P<0.05);the increment was more obvious in dexamethasone group (P<0.05). The two groups of patients showed no significant difference in liver functions after the operation. None of the patients developed upper gastrointestinal hemorrhage or spleen abscess. Conclusion Intravenous dexamethasone produces better therapeutic effect than oral NSAIDs in the management of partial splenic embolization syndrome.