部分脾栓塞术与全脾切除术治疗肝硬化脾功能亢进患者的效果比较  

Comparison on the curative effect of partial splenic embolization and total splenectomy on patients with cirrhosis and hypersplenism

作　　者：罗凡昌 LUO Fanchang(Department of General Surgery,Jingzhou Third People's Hospital,Hubei Province,Jingzhou434300,China)

机构地区：[1]湖北省荆州市第三人民医院普外科,湖北荆州434300

出　　处：《中国当代医药》2022年第34期23-26,共4页China Modern Medicine

摘　　要：目的探究部分脾栓塞术(PSE)与全脾切除术对肝硬化脾功能亢进患者血清补体C3、C4水平的影响。方法选取2019年1月至2021年3月在湖北省荆州市第三人民医院进行手术治疗的90例肝硬化脾功能亢进患者作为研究对象,采用随机数字表法分为PSE组(n=45)与全切组(n=45),PSE组采用PSE术治疗,全切组采用全脾切除术治疗。比较两组患者手术相关指标,术前与术后6个月血流动力学指标和炎症介质水平及血清补体C3、C4水平。结果PSE组手术、住院时间短于全切组,术中出血量少于全切组,差异有统计学意义(P<0.05);两组患者术后的门静脉内径、门静脉流速、门脉压力与肿瘤坏死因子-α(TNF-α)水平低于本组术前,差异有统计学意义(P<0.05);两组患者术后的门静脉内径、门静脉流速、门脉压力比较,差异无统计学意义(P>0.05);PSE组患者术后的TNF-α水平低于全切组,差异有统计学意义(P<0.05);两组患者术后的补体C3、C4水平高于本组术前,差异有统计学意义(P<0.05);PSE组补患者术后的体C3、C4水平高于全切组,差异有统计学意义(P<0.05)。结论PSE与全脾切除术均具良好治疗效果,PSE效果更佳,可缩短手术时间,减少术中出血,缓解机体应激,改善补体C3、C4水平,促进患者康复。Objective To explore the effects of partial splenic embolization(PSE)and total splenectomy on levels of serum complements C3 and C4 in patients with cirrhosis and hypersplenism.Methods A total of 90 patients with cirrhosis and hypersplenism undergoing surgical treatment in Jingzhou Third People's Hospital were enrolled as the research objects from January 2019 to March 2021,and they were divided into PSE group(n=45)and total splenectomy group(n=45)according to random number table method.PSE group was treated with PSE,and total splenectomy group was treated with tatal splenectomy.The surgical related indexes,levels of hemodynamic indexes,inflammatory mediators,serum complements C3 and C4 before and at 6 months after surgery were compared between the two groups.Results The operation time and hospitalization time in PSE group were shorter than those in total splenectomy group,and intraoperative blood loss was less than that in total splenectomy group,with statistically significant differences(P<0.05).The postoperative portal vein diameter,portal vein flow rate,portal vein pressure and tumor necrosis factor-α(TNF-α)levels in two groups were lower than those before surgery,and the differences were statistically significant(P<0.05).After surgery,there were no significant differences in portal vein diameter,portal vein flow rate and portal pressure between the two groups(P>0.05).After surgery,the level of TNF-αin PSE group was lower than that in total resection group,and the difference was statistically significant(P<0.05).The levels of complement C3 and C4 in two groups after surgery were higher than those before surgery,and the differences were statistically significant(P<0.05).The postoperative levels of C3 and C4 in PSE group were higher than those in total resection group,and the differences were statistically significant(P<0.05).Conclusion Compared with total splenectomy,curative effect of PSE is better,which can shorten operation time,reduce intraoperative blood loss,relieve body stress,improve levels of compl

关 键 词：部分脾栓塞术 全脾切除术 肝硬化 脾功能亢进 血清补体 

分 类 号：R657.3[医药卫生—外科学]