脾切除术与脾动脉栓塞术治疗肝硬化脾亢疗效的比较  

Comparison of effects on treatment of cirrhotic hypersplenism between splenetomy and splenic artery embolization

作　　者：邓美海[1] 汤照峰[1] 许瑞云[1] 潘卫东[1] 

机构地区：[1]中山大学附属第三医院肝胆外科,广东广州510630

出　　处：《中国现代医学杂志》2006年第12期1858-1860,1863,共4页China Journal of Modern Medicine

基　　金：广东省科技计划项目(2004B35001007)

摘　　要：目的比较脾切除术与脾动脉栓塞术治疗乙肝肝硬化脾功能亢进的近期疗效。方法乙肝肝硬化并脾亢患者76例分成脾切除术组和脾栓塞术组,观察比较术后1周时脾亢改善情况及发热和腹痛等并发症的发生情况。结果两组患者脾亢均得到一定的改善,脾切除术组纠正脾亢的效果明显好于脾栓塞术组。脾栓塞术组的32例患者中,术后1周时有18例血小板<10.0×109/L(占56.3%),而脾切除术组44例患者血小板均>10.0×109/L。两组患者术后均有一定比例并发症的发生。结论脾切除术治疗乙肝肝硬化并发脾功能亢进的近期疗效明显好于脾动脉栓塞术。[Objective] To compare spleneetomy with splenic artery embolization in short-term curative effects on hypersplenism of the cirrhotic portal hypertension of post-hepatitis B. [Methods] 76 patients with hypersplenism were divided into spleneetomy and splenic embolization group, The two groups of patients were compared for early remission of hypersplenism and incidence of complications at the end of I week subsequent to the operation or splenic embolization. [Results] Both two groups of patients obtained insignificant improvement in terms of hyperplenism, and spleneetomy group was significantly better than splenic embolization group in the remission of hypersplenism. Of 32 patients who underwent splenic artery embolization, 18 had thromboeytopenia with a platelet count of 〈10.0×10^9/L, while 44 patients of the splenectomy group had no thromboeytopenia with a platelet count of 〉10.0×10^9/L one week after treatment. Two groups of patients had certain proportion incidence of complications. [Conclusions] Splenectomy is significantly better than partial splenic artery embolization in short-term curative effects on hypersplenism of the cirrhotic portal hylpertension of post-hetpatitis B.

关 键 词：乙型肝炎 肝硬化 脾功能亢进 脾切除术 脾动脉栓塞术 

分 类 号：R657.34[医药卫生—外科学]