CAJ | 학술논문

目的：探讨临床治疗原发性肝癌合并脾功能亢进的有效方案。方法：回顾分析163例原发性肝癌合并脾功能亢进患者的临床资料，根据治疗方案将上述患者分为观察组（n=83）与对照组（n=80），观察组接受肝癌切除术联合全脾切除术治疗，对照组仅接受肝癌切除术治疗。结果：（1）两组患者术中出血量、输血量比较差异无统计学意义（P>0.05）。（2）术前，两组患者红细胞（RBC）、白细胞（WBC）、血小板（PLT）比较差异无统计学意义（P>0.05）；术后2个月，观察组WBC、PLT显著高于对照组（P<0.05），两组患者RBC比较差异无统计学意义（P>0.05）。（3）术前，两组患者CD4、CD8、CD4/CD8比较差异无统计学意义（P>0.05）；术后2个月，观察组CD4、CD4/CD8显著高于对照组（P<0.05），CD8显著低于对照组（P<0.05）。（4）两组患者并发症发生率、病死率比较差异无统计学意义（P>0.05）。结论：肝癌切除术联合全脾切除术是治疗原发性肝癌合并脾功能亢进的有效方案，该方案值得临床应用与推广。
목적：탐토림상치료원발성간암합병비공능항진적유효방안。방법：회고분석163례원발성간암합병비공능항진환자적림상자료，근거치료방안장상술환자분위관찰조（n=83）여대조조（n=80），관찰조접수간암절제술연합전비절제술치료，대조조부접수간암절제술치료。결과：（1）량조환자술중출혈량、수혈량비교차이무통계학의의（P>0.05）。（2）술전，량조환자홍세포（RBC）、백세포（WBC）、혈소판（PLT）비교차이무통계학의의（P>0.05）；술후2개월，관찰조WBC、PLT현저고우대조조（P<0.05），량조환자RBC비교차이무통계학의의（P>0.05）。（3）술전，량조환자CD4、CD8、CD4/CD8비교차이무통계학의의（P>0.05）；술후2개월，관찰조CD4、CD4/CD8현저고우대조조（P<0.05），CD8현저저우대조조（P<0.05）。（4）량조환자병발증발생솔、병사솔비교차이무통계학의의（P>0.05）。결론：간암절제술연합전비절제술시치료원발성간암합병비공능항진적유효방안，해방안치득림상응용여추엄。
Objective:To investigate the effective regimen for primary hepatocellular carcinoma with hypersplenism.Method:The clinical data of 163 cases of primary hepatocellular carcinoma with hypersplenism were analyzed retrospectively.According to the surgical regimen,these patients were divided into an observation group(n=83)and a control group(n=80),and the observation group received liver cancer resection combined with splenectomy,while the control group received liver cancer resection only.Result:(1)No significant differences were found in perioperative blood loss and blood transfusion volume between the 2 groups(P>0.05).(2)Before surgery,no significant differences were found in red blood cell(RBC), white blood cell(WBC)and platelet(PLT)between the 2 groups(P>0.05). 2 months after surgery,the WBC and PLT in the observation group were statistically higher than those in the control group respectively(P<0.05),while no significant difference in RBC was found between the 2 groups(P>0.05).(3) Before surgery,no significant differences were found in CD4,CD8 and CD4/CD8 between the 2 groups(P>0.05). 2 months after surgery,the CD4 and CD4/CD8 in the observation group were statistically higher than those in the control group respectively(P<0.05),while the CD8 was lower than that in the control group(P<0.05).(4)No significant differences were found in complication rate and mortality rate between the 2 groups(P>0.05).Conclusion:The liver cancer resection combined with splenectomy is an effective regimen for primary hepatocellular carcinoma with hypersplenism,and this surgical regimen is worthy of being applied and popularized.