CAJ | 학술논문

目的：探讨肝炎后肝硬化门静脉高压性脾肿大病人外周血细胞减少与手术疗效，阐明肝炎后肝硬化门静脉高压性脾肿大病人脾切除术后何种外周血细胞减少与手术疗效的关系最为密切。方法选择肝炎后肝硬化门静脉高压性脾肿大病人366例。根据术前血细胞的减少，分为单种血细胞减少组，两种血细胞减少组和多种血细胞减少组；手术前后与随访期间检测血细胞。全组均行切除脾脏＋贲门周围血管离断术。运用 SPSS13．0统计软件，单因素比较采用K-W秩和检验进行数据处理，多单因素比较采用多元线性回归分析，P＜0．05为显著性差异。结果术后患者血白细胞及血小板明显升高，随访期间疗效持久稳定；术后监测患者免疫球蛋白升高明显；随访1，2年期间患者再出血率明显减少。在单种血细胞减少组中，只有红细胞组内疗效比较有显著性差异（P＜0．05），但随着病例数的增加，累积的 RBC组内疗效比较又无显著性差异（P＞0．05），而累积的 PLT减少则呈现显著性差异（P＜0．05）。在多种血细胞减少组中，PLT减少与 WBC减少及 RBC减少比较有明显差异（P＜0．05）。术后疗效单种血细胞减少组与多种血细胞减少组比较有明显差异（P＜0．05）。结论外周血细胞减少的程度与疗效有明显关系，单种血细胞减少组的疗效明显优于多种血细胞减少组，PLT减少是影响手术疗效的主要因素，减少越严重疗效越差。
목적：탐토간염후간경화문정맥고압성비종대병인외주혈세포감소여수술료효，천명간염후간경화문정맥고압성비종대병인비절제술후하충외주혈세포감소여수술료효적관계최위밀절。방법선택간염후간경화문정맥고압성비종대병인366례。근거술전혈세포적감소，분위단충혈세포감소조，량충혈세포감소조화다충혈세포감소조；수술전후여수방기간검측혈세포。전조균행절제비장＋분문주위혈관리단술。운용 SPSS13．0통계연건，단인소비교채용K-W질화검험진행수거처리，다단인소비교채용다원선성회귀분석，P＜0．05위현저성차이。결과술후환자혈백세포급혈소판명현승고，수방기간료효지구은정；술후감측환자면역구단백승고명현；수방1，2년기간환자재출혈솔명현감소。재단충혈세포감소조중，지유홍세포조내료효비교유현저성차이（P＜0．05），단수착병례수적증가，루적적 RBC조내료효비교우무현저성차이（P＞0．05），이루적적 PLT감소칙정현현저성차이（P＜0．05）。재다충혈세포감소조중，PLT감소여 WBC감소급 RBC감소비교유명현차이（P＜0．05）。술후료효단충혈세포감소조여다충혈세포감소조비교유명현차이（P＜0．05）。결론외주혈세포감소적정도여료효유명현관계，단충혈세포감소조적료효명현우우다충혈세포감소조，PLT감소시영향수술료효적주요인소，감소월엄중료효월차。
Objective To investigate hepatitis liver cirrhosis portal hypertension patients with splenic enlargement after reduction and peripheral blood cells Surgical curative effect.Methods Between January 1991 and December 1991, the author's hospitals liver cirrhosis portal vein Compressional splenomegaly patients the clinical data of 3 6 6 cases.U-sing SPSS13.0 statistical software,single Factor Compare the K-W rank of testing and data processing,single factor comparison using multivariate linear back more To return analysis,P<0.05 is significant difference.Results Of three types of blood counts are normal 3 6 cases (9.8%),and more than a peripheral blood Cell to reduce 330 cases,of which the single kind of blood cell reduction in 99 cases (30.0%),two kinds of blood cells Less 118 cases (35.8%),three types of blood cells counts were reduced,113 cases (34.2%),the whole group Excision of spleen+door,block or by-pass surgery,in single cells reduce group,only the RBC Curative effect comparison in the group have significant differ-ence (P< 0.05),but with the increase of the number of cases,and accumulated Comparative effectiveness of RBC group and there was no significant difference (P>0.05),and the accumulation of PLT decrease Show significant differ-ence (P<0.05),in a variety of blood cells decrease in the group,the PLT decrease With The WBC and RBC decrease compared with significant difference (P<0.05).A single blood fine curative effect after surgery Cell reduce groups with a variety of blood group had significant difference (P<0.05).Conclusion To reduce the degree of peripheral blood cells have obvious relationship with curative effect,a single blood cell reduction group Curative effect is superior to a variety of blood cell reduction group,the PLT decrease is mainly due to the operation curative effect And reduce the serious effect of the poor.