脾切除贲门周围血管离断术对患者肝功能的影响  

Changes in liver function in patients who underwent splenectomy and pericardial devascularization

作　　者：张鹰[1] 李志伟[1] 赵新[1] 张昆[1] 齐瑞兆[1] 杨景惠[1] 洪智贤[1] 王兆海[1] 张绍庚[1] 

机构地区：[1]解放军第302医院肝胆外科,北京100039

出　　处：《中华肝胆外科杂志》2017年第2期117-120,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨脾切除贲门周围血管离断术治疗肝硬化门静脉高压症患者近远期的肝功能变化。方法回顾性分析2012年12月至2013年12月在我院行脾切除贲门血管离断术的59例肝硬化门静脉高压患者术前术后肝功能相关数据，对比分析术前术后肝功能的变化。结果59例患者术前肝功能Child评分（6．1±1．0）与术后12日肝功能Child评分（6．2±0．9）变化差异无统计学意义（P〉0．05）。术前胆碱酯酶（4057．6±1364．2）U／L与术后12日胆碱酯酶（2709．1±1072．5）U／L差异有统计学意义（P〈0．05），术后近期胆碱酯酶较术前降低。术前肝功能Child评分（6．1±1．0）与术后3个月（5．7±0．8）、6个月（5．5±0．8）、12个月肝功能评分（5．5±0．8）差异有统计学意义（P〈0．05），术后远期肝功较术前明显好转。术前胆碱酯酶（4057．6±1364．2）U／L与术后3个月（4881．3±1601．7）U／L、6个月（5135．5±1688．2）U／L、12个月（5295．9±1695．0）U／L差异有统计学意义（P〈0．05），术后远期胆碱酯酶较术前增加。结论脾切除贲门周围血管离断术后近期（围手术期）患者肝功能无显著变化，远期肝功能好转。Objective To study the changes in liver function in patients with cirrhosis and portal hypertension who underwent splenectomy and pericardial devascularization. Methods Patients with cirrho- sis and portal hypertension treated in our hospital from December 2012 to December 2013 were studied and their clinical data were retrospectively analyzed. Results 59 patients with cirrhosis and portal hypertension underwent splenectomy and peficardial devaseularization. The Child-Pugh scores in the preoperative period, 12 days, 3 months, 6 months and 12 months after operation were 6.1 ± 1.0, 6.2 ±0.9, 5.7 ±0.8, 5.5 ± 0.8, 5.5 ±0.8, respectively. The cholinesterase levels in the preoperative period, 12 days, 3 months, 6 months and 12 months after operation were 4 057.6 ± 1 364.2, 2 709. 1 ± 1 072.5, 4 881.3 ± 1 601.7, 5 135.5 ± 1 688.2, 5 295.9 ± 1 695.0 U/L, respectively. Conclusion For patients who underwent splenectomy and pericardial devascularization, the liver function was stable in the perioperative period, and improved in the long term after operation.

关 键 词：肝硬化 门静脉高压 脾切除 贲门周围血管离断术 肝功能 

分 类 号：R657.34[医药卫生—外科学]