脾切除术后抗病毒治疗对丙型肝炎肝硬化伴脾功能亢进患者5年生存质量的影响  

Influence of antiviral treatment after splenectomy on 5-year survival quality in patients with hepatitis C cirrhosis and sthenic splenic function

作　　者：程莉 陈少华 

机构地区：[1]湖北省应城市人民医院感染科,湖北应城432400

出　　处：《临床军医杂志》2015年第4期377-380,共4页Clinical Journal of Medical Officers

摘　　要：目的探讨脾切除术后抗病毒治疗对丙型肝炎肝硬化伴脾功能亢进患者5年生存质量的影响。方法选取丙型肝炎肝硬化伴脾功能亢进患者120例,根据是否行脾切除术分为脾切除组(66例)与非手术治疗组(54例),再根据患者是否行抗病毒治疗分为抗病毒治疗者与未行抗病毒治疗者,抗病毒治疗需最少连续治疗1年以上,两组患者治疗前及治疗5年时行肝病生存质量问卷(CLDQ)、世界卫生组织生存质量综合评定问卷(WHOQOL-BREF)调查,比较生存质量。结果两组患者治疗前、治疗5年时CLDQ、WHOQOL-BREF总评分组间比较差异无统计学意义(P>0.05),两组患者治疗5年时CLDQ、WHOQOL-BREF总评分均较治疗前升高,两组内治疗前后比较差异有统汁学意义(P<0.01);两组抗病毒治疗患者CLDQ、WHOQOL-BREF总评分均高于本组未行抗病毒治疗者(P<0.05或P<0.01),脾切除组抗病毒治疗患者CLDQ、WHOQOL-BREF总评分均高于非手术治疗组抗病毒治疗者(P<0.05或P<0.01),脾切除组未行抗病毒治疗者与非手术治疗组未行抗病毒治疗者及非手术治疗组抗病毒治疗者CLDQ、WHOQOL-BREF总评分比较差异无统计学意义(P>0.05)。结论脾切除术后联合抗病毒治疗较未进行抗病毒治疗及单纯药物非手术治疗可明显改善患者的5年生存质量。Objective To investigate the influence of antiviral treatment after splenectomy on 5-year survival quality in patients with hepatitis C cirrhosis and sthenic splenic function.Methods A total of 120 patients with hepatitis c cirrhosis and sthenic splenic function were divided into splenectomy group （n =66） and non-surgery group （n =54） according to whether the patients underwent splenectomy or not.The two groups were further divided into antiviral treatment subgroups （treated with antiviral treatment for at least one year） and non-antiviral treatment subgroups.Before treatment and after five years＇ treatment,investigation by questionnaire was performed.Results The differences in the total scores of liver disease quality of life questionnaire and World Health Organization quality of life questionnaire were no statistical significance before treatment and after five years＇ treatment between the two groups （P ＞ 0.05）.Both the two groups got significant increases in the total scores after five years＇ treatment when compared with before treatment （P ＜ 0.05）,and the total scores were significantly higher in the antiviral treatment subgroups than in the non-antiviral treatment subgroups （P ＜ 0.05 or P ＜ 0.01）.The antiviral treatment subgroup of the splenectomy group was significantly higher at the total scores than that of the non-surgery group （P ＜ 0.05 or P ＜ 0.01）,and there were no significant differences between the non-antiviral treatment subgroup of the splenectomy group and that of the non-surgery group （P ＞ 0.05）.Conclusion Antiviral therapy after splenectomy helps to improve the 5-year survival quality of the patients with hepatitis C and cirrhosis of liver.

关 键 词：丙型肝炎 肝硬化 脾功能亢进 脾切除 抗病毒 生存质量 

分 类 号：R657.63[医药卫生—外科学]