CAJ | 학술논문

目的：探究肝脾双介入治疗原发性肝癌并脾亢的临床疗效。方法选取原发性肝癌并脾亢患者87例，随机分为对照组（n=43）和治疗组（n=44），对照组患者行肝动脉化疗栓塞术治疗，治疗组患者行肝动脉化疗栓塞术联合部分脾动脉栓塞术治疗。观察2组患者术后血象变化、食管胃底静脉曲张程度以及不良反应情况。结果治疗组患者术后1周、2周和4周白细胞计数分别为（7.13±2.08）×109/L、（6.57±1.82）×109/L和（4.35±1.64）×109/L，血小板计数分别为（92.12±13.76）×109/L、（95.03±16.57）×109/L和（89.97±18.72）×109/L，治疗组患者术后1周、2周和4周白细胞和血小板计数均高于治疗前，差异有统计学意义（P<0.05）。对照组患者术后1周、2周和4周白细胞计数分别为（3.07±1.12）×109/L、（3.74±1.25）×109/L和（3.28±1.39）×109/L，血小板计数分比为（43.01±11.27）×109/L、（47.15±10.97）×109/L和（52.12±11.23）×109/L，对照组患者术后1周血小板计数与术前相比差异有统计学意义（P<0.05），且2组患者术后1周、2周和4周2项指标水平比较差异有统计学意义（P<0.05）。经胃镜检查，治疗组患者中轻度食管胃底静脉曲张29例，中度9例，重度6例，对照组中轻度18例，中度10例，重度15例，治疗组患者食管胃底静脉曲张程度改善优于对照组，2组比较差异有统计学意义（P<0.05）。术后治疗组患者不良反应发生率为77.3%，对照组患者不良反应发生率为76.7%，2组患者不良反应发生率比较差异无统计学意义。结论采用肝动脉化疗栓塞术联合部分脾动脉栓塞术治疗原发性肝癌并脾亢，有效改善患者血象，降低门脉压力，减少上消化道出血并发症发生率，治疗效果显著，值得临床推广。
목적：탐구간비쌍개입치료원발성간암병비항적림상료효。방법선취원발성간암병비항환자87례，수궤분위대조조（n=43）화치료조（n=44），대조조환자행간동맥화료전새술치료，치료조환자행간동맥화료전새술연합부분비동맥전새술치료。관찰2조환자술후혈상변화、식관위저정맥곡장정도이급불량반응정황。결과치료조환자술후1주、2주화4주백세포계수분별위（7.13±2.08）×109/L、（6.57±1.82）×109/L화（4.35±1.64）×109/L，혈소판계수분별위（92.12±13.76）×109/L、（95.03±16.57）×109/L화（89.97±18.72）×109/L，치료조환자술후1주、2주화4주백세포화혈소판계수균고우치료전，차이유통계학의의（P<0.05）。대조조환자술후1주、2주화4주백세포계수분별위（3.07±1.12）×109/L、（3.74±1.25）×109/L화（3.28±1.39）×109/L，혈소판계수분비위（43.01±11.27）×109/L、（47.15±10.97）×109/L화（52.12±11.23）×109/L，대조조환자술후1주혈소판계수여술전상비차이유통계학의의（P<0.05），차2조환자술후1주、2주화4주2항지표수평비교차이유통계학의의（P<0.05）。경위경검사，치료조환자중경도식관위저정맥곡장29례，중도9례，중도6례，대조조중경도18례，중도10례，중도15례，치료조환자식관위저정맥곡장정도개선우우대조조，2조비교차이유통계학의의（P<0.05）。술후치료조환자불량반응발생솔위77.3%，대조조환자불량반응발생솔위76.7%，2조환자불량반응발생솔비교차이무통계학의의。결론채용간동맥화료전새술연합부분비동맥전새술치료원발성간암병비항，유효개선환자혈상，강저문맥압력，감소상소화도출혈병발증발생솔，치료효과현저，치득림상추엄。
Objective To explore the clinical effect of Hepatosplenic interventional in the treatment of primary liver cancer with spleen function hyperthyroidism.Methods 87 cases with primary liver cancer with spleen function hyperthyroidism were randomly divided into the control group (n=43) and the treatment group (n=44). The control group was given Hepatic arterial chemoembolization. The treatment group was received Hepatic arterial chemoembolization and partial splenic artery embolization. Observed changes in blood After surgery, hemogram, degree of esophageal gastric varices and adverse reactions in the two groups were compared.Results The number of white blood cells in the treatment group were 1 (7.13±2.08)×109/L, (6.57±1.82)×109/L, (4.35±1.64)×109/L, the platelet count was (92.12±13.76) ×109/L, (95.03±16.57) ×109/L, (89.97±18.72)×109/L, in the treatment group, 1 weeks, 2 weeks and 4 weeks after operation, the white blood cell and platelet count were higher than before treatment (P<0.05), the difference was statistically significant. In control group, 1 weeks, 2 weeks and 4 weeks white blood cell count were (3.07±1.12)×109/L, (3.74±1.25)×109/L and (3.28±1.39 )×109/L, platelet count score was (43.01±11.27)×109/L, (47.15±10.97)×109/L and (52.12±11.23)×109/L, there was significant difference between the 1 weeks after operation in the control group (P<0.05), and the two groups of patients after 1 weeks, 2 weeks and 4 weeks of the two indicators were statistically different (P<0.05). In the treatment group, 29 patients with mild esophageal varices were treated with endoscopy, 9 cases with moderate and 6 cases with severe esophageal varices, while 18 cases with mild to moderate and 10 cases with moderate and severe 15 cases in the control group, the degree of esophageal gastric varices in treatment group was better than that in control group, the difference was statistically significant (P<0.05). The incidence of adverse reactions in the treatment group was 77.3%, the incidence of adverse reactions in the control group was 76.7%, there was no significant difference in the incidence of adverse reactions between the two groups.Conclusion It can improve hemogram, reduce portal pressure, reduce the incidence of upper gastrointestinal bleeding that Hepatic arterial chemoembolization combined with partial splenic embolization were used in the treatment of primary liver cancer with spleen function hyperthyroidism. It is worthy of promotion .