CAJ | 학술논문

目的：探讨自身免疫性肝炎后肝硬化伴脾功能亢进行脾切除术的治疗效果。方法对自身免疫性肝炎后肝硬化伴脾功能亢进9例患者行脾切除术及贲门周围血管断流术。结果9例患者恢复良好，术后2周肝功能恢复到术前水平，手术前后转氨酶、胆红素变化差异无统计学意义（P＞0．05），白细胞及血小板升至正常水平，较术前差异有统计学意义（P＜0．05），脾功能亢进症状得到纠正，凝血功能较前明显好转，差异有统计学意义（P＜0．05）。术后随访12～18个月无一例再发消化道出血，行贲门周围血管离断术术后3个月复查胃镜提示食道静脉曲张较前好转。结论脾切除及贲门周围血管断流术是自身免疫性肝炎后肝硬化失代偿期的一项有效措施，对改善患者脾功能亢进、提高患者的凝血功能，减少出血有较明显的作用。
목적：탐토자신면역성간염후간경화반비공능항진행비절제술적치료효과。방법대자신면역성간염후간경화반비공능항진9례환자행비절제술급분문주위혈관단류술。결과9례환자회복량호，술후2주간공능회복도술전수평，수술전후전안매、담홍소변화차이무통계학의의（P＞0．05），백세포급혈소판승지정상수평，교술전차이유통계학의의（P＜0．05），비공능항진증상득도규정，응혈공능교전명현호전，차이유통계학의의（P＜0．05）。술후수방12～18개월무일례재발소화도출혈，행분문주위혈관리단술술후3개월복사위경제시식도정맥곡장교전호전。결론비절제급분문주위혈관단류술시자신면역성간염후간경화실대상기적일항유효조시，대개선환자비공능항진、제고환자적응혈공능，감소출혈유교명현적작용。
Objective To investigate the effect of splenectomy on autoimmune hepatitis complicated with cirrhosis and hypersplenism.Methods Nine cases of autoimmune hepatitis complicated withcirrhosis and hypersplenism were treated with splenectomy and periesophagogastric devascularization.Results All patients recovered well.Their liver functions recovered to the preoperative level within twoweeks after operation.No significant differences were found between preoperative and postoperative levelsof transaminase and bilirubin(P >0.05).The count of leukocyte and platelet rose to the normal level andthere were significant differences between the preoperative and postoperative levels(P <0.05).Patients'symptoms of hypersplenism were corrected and their coagulation function improved significantly (P <0.05).Conclusion In patients with autoimmune hepatitis complicated with cirrhosis and hypersplenism,splenectomy with periesophagogastric devascularization is an effective procedure for improving hypersplenism,enhancing blood coagulation,and reducing bleeding.