实用肝脏病杂志
實用肝髒病雜誌
실용간장병잡지
Journal of Practical Hepatology
2015年
6期
624-627
,共4页
肝硬化%脾切除术%脾动脉部分栓塞术%肝功能
肝硬化%脾切除術%脾動脈部分栓塞術%肝功能
간경화%비절제술%비동맥부분전새술%간공능
Liver cirrhosis%Splenectomy%Partial splenic artery embolization%Liver function
目的:观察失代偿期乙型肝炎肝硬化患者行脾切除术或脾动脉部分栓塞术的疗效。方法选择我院2010年2月~2013年2月收治的采用脾切除术治疗的失代偿期乙型肝炎肝硬化患者50例和采用脾动脉部分栓塞术治疗的失代偿期乙型肝炎肝硬化患者28例。另选择我院同期收治入院的采用常规保守治疗的患者30例作为对照组。结果随访3组患者治疗后1年,对照组外周血白细胞和血小板计数分别为(3.3±0.6)×109/L和(56.3±5.8)×109/L,显著低于脾切除组(6.2±0.6)×109/L和(126.5±12.7)×109/L(P<0.05),或脾动脉栓塞组(7.2±0.8)×109/L和(112.8±10.6)×109/L(P<0.05);对照组 CD4、CD4/CD8比值和白蛋白分别为(32.5±3.5)%、(1.1±0.2)和(24.9±3.8) g/L,显著低于脾切除组(41.8±4.2)%、(1.9±0.2)和(29.1±3.7) g/L(P<0.05),或脾动脉栓塞组(41.6±4.9)%、(1.7±0.2)和(28.2±4.0) g/L(P<0.05),而CD8、TBIL、ALT、PT分别为(32.3±4.7)%、(42.7±21.5)μmol/L、(67±35) IU/L、(24.8±3.4) s,显著高于脾切除组(22.7±3.4)%、(29.2±12.4)μmol/L、(40±26) IU/L、(16.2±3.4) s(P<0.05),或脾动脉栓塞组(23.0±3.6)%、(35.2±13.4)μmol/L、(56±20) IU/L、(16.5±2.9)s(P<0.05);对照组膈下感染、肺部感染、肺不张、脾静脉炎、上消化道出血发生率分别为43.3%、56.7%、26.7%、20.0%、23.3%,显著高于脾切除组的12.0%、14.0%、6.0%、4.0%、8.0%(P<0.05),或脾动脉栓塞组的10.7%、14.3%、3.6%、3.6%、7.1%(P<0.05)。结论脾切除术或脾动脉部分栓塞术后,患者肝功能稳定,不同程度地减少了感染和上消化道出血的发生率。
目的:觀察失代償期乙型肝炎肝硬化患者行脾切除術或脾動脈部分栓塞術的療效。方法選擇我院2010年2月~2013年2月收治的採用脾切除術治療的失代償期乙型肝炎肝硬化患者50例和採用脾動脈部分栓塞術治療的失代償期乙型肝炎肝硬化患者28例。另選擇我院同期收治入院的採用常規保守治療的患者30例作為對照組。結果隨訪3組患者治療後1年,對照組外週血白細胞和血小闆計數分彆為(3.3±0.6)×109/L和(56.3±5.8)×109/L,顯著低于脾切除組(6.2±0.6)×109/L和(126.5±12.7)×109/L(P<0.05),或脾動脈栓塞組(7.2±0.8)×109/L和(112.8±10.6)×109/L(P<0.05);對照組 CD4、CD4/CD8比值和白蛋白分彆為(32.5±3.5)%、(1.1±0.2)和(24.9±3.8) g/L,顯著低于脾切除組(41.8±4.2)%、(1.9±0.2)和(29.1±3.7) g/L(P<0.05),或脾動脈栓塞組(41.6±4.9)%、(1.7±0.2)和(28.2±4.0) g/L(P<0.05),而CD8、TBIL、ALT、PT分彆為(32.3±4.7)%、(42.7±21.5)μmol/L、(67±35) IU/L、(24.8±3.4) s,顯著高于脾切除組(22.7±3.4)%、(29.2±12.4)μmol/L、(40±26) IU/L、(16.2±3.4) s(P<0.05),或脾動脈栓塞組(23.0±3.6)%、(35.2±13.4)μmol/L、(56±20) IU/L、(16.5±2.9)s(P<0.05);對照組膈下感染、肺部感染、肺不張、脾靜脈炎、上消化道齣血髮生率分彆為43.3%、56.7%、26.7%、20.0%、23.3%,顯著高于脾切除組的12.0%、14.0%、6.0%、4.0%、8.0%(P<0.05),或脾動脈栓塞組的10.7%、14.3%、3.6%、3.6%、7.1%(P<0.05)。結論脾切除術或脾動脈部分栓塞術後,患者肝功能穩定,不同程度地減少瞭感染和上消化道齣血的髮生率。
목적:관찰실대상기을형간염간경화환자행비절제술혹비동맥부분전새술적료효。방법선택아원2010년2월~2013년2월수치적채용비절제술치료적실대상기을형간염간경화환자50례화채용비동맥부분전새술치료적실대상기을형간염간경화환자28례。령선택아원동기수치입원적채용상규보수치료적환자30례작위대조조。결과수방3조환자치료후1년,대조조외주혈백세포화혈소판계수분별위(3.3±0.6)×109/L화(56.3±5.8)×109/L,현저저우비절제조(6.2±0.6)×109/L화(126.5±12.7)×109/L(P<0.05),혹비동맥전새조(7.2±0.8)×109/L화(112.8±10.6)×109/L(P<0.05);대조조 CD4、CD4/CD8비치화백단백분별위(32.5±3.5)%、(1.1±0.2)화(24.9±3.8) g/L,현저저우비절제조(41.8±4.2)%、(1.9±0.2)화(29.1±3.7) g/L(P<0.05),혹비동맥전새조(41.6±4.9)%、(1.7±0.2)화(28.2±4.0) g/L(P<0.05),이CD8、TBIL、ALT、PT분별위(32.3±4.7)%、(42.7±21.5)μmol/L、(67±35) IU/L、(24.8±3.4) s,현저고우비절제조(22.7±3.4)%、(29.2±12.4)μmol/L、(40±26) IU/L、(16.2±3.4) s(P<0.05),혹비동맥전새조(23.0±3.6)%、(35.2±13.4)μmol/L、(56±20) IU/L、(16.5±2.9)s(P<0.05);대조조격하감염、폐부감염、폐불장、비정맥염、상소화도출혈발생솔분별위43.3%、56.7%、26.7%、20.0%、23.3%,현저고우비절제조적12.0%、14.0%、6.0%、4.0%、8.0%(P<0.05),혹비동맥전새조적10.7%、14.3%、3.6%、3.6%、7.1%(P<0.05)。결론비절제술혹비동맥부분전새술후,환자간공능은정,불동정도지감소료감염화상소화도출혈적발생솔。
Objective To observe the efficacy of patients with decompensated hepatitis B cirrhosis after splenectomy or partial splenic artery embolization. Methods 108 patients with decompensated hepatitis B-related liver cirrhosis were recruited in this study,and 50 received splenectomy,28 received partial splenic artery embolization and 30 received conventional medical therapy as control. Results At the end of one-year follow-up,the peripheral white blood cell and platelet counts in control group were(3.3±0.6)í109/L and(56.3±5.8)í109/L, significantly lower than in spleen resection group(6.2±0.6)í109/L and(126.5±12.7)í109/L(P<0.05),or in partial splenic artery embolization group(7.2±0.8)í109/L and (112.8±10.6)í109/L(P<0.05);the peripheral blood CD4,CD4/CD8 ratio and albumin levels were (32.5±3.5)%,(1.1±0.2)and (24.9±3.8) g/L,significantly lower than in patients with splenectomy (41.8±4.2)%,(1.9±0.2) and (29.1±3.7) g/L (P<0.05),or in with partial splenic artery embolization (41.6±4.9)%,(1.7±0.2) and (28.2±4.0) g/L (P<0.05);the CD8,bilirubin,ALT and prothrombin time were(32.3±4.7)%,(42.7±21.5)μmol/L,(67±35) IU/L and(24.8±3.4)s,significantly higher than in spleen resection group(22.7±3.4)%,(29.2±12.4)μmol/L,(40±26) IU/L and (16.2±3.4)s(P<0.05),or in with partial splenic artery embolization (23.0±3.6)%,(35.2±13.4)μmol/L,(56±20) IU/L and (16.5±2.9)s (P<0.05);the incidences of subphrenic infection,pulmonary infection,pulmonary atelectasis,splenic vein inflammation,upper gastrointestinal bleeding were 43.3%,56.7%,26.7%,20.0%,23.3%,significantly higher than in spleen resection group (12.0%, 14.0%,6.0%,4.0%,8.0%,P<0.05),or in with partial splenic artery embolization (10.7%,14.3%,3.6%,3.6%,7.1%, P<0.05). Conclusion The liver function improves in patients with liver cirrhosis after receiving splenectomy or partial splenic artery embolization.