部分脾栓塞术对肝硬化脾功能亢进患者炎症反应及凝血功能的影响  

Effect of partial splenic embolization on inflammatory response and coagulation in patients with hypersplenism in liver cirrhosis

作　　者：白露[1] 李庆刚 BAI Lu;LI Qinggang(Department of Infection,First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 410005)

机构地区：[1]郑州大学第一附属医院感染科,河南郑州410005

出　　处：《临床研究》2023年第8期36-38,共3页Clinical Research

摘　　要：目的分析部分脾栓塞术(PSE)对肝硬化脾功能亢进患者炎症反应及凝血功能的影响。方法选择郑州大学第一附属医院2022年1月至2023年2月收治的78例肝硬化脾功能亢进患者按照随机数字表法将其划分为全切治疗组(接受全脾切除术)和PSE治疗组(接受部分脾栓塞术),各39例。检测两组患者术前、术后的炎症因子水平、血流动力学指标、凝血功能水平及术中指标、住院时间、并发症发生率。结果术前,两组炎症因子水平、血流动力学指标、凝血功能水平比较,差异无统计学意义(P>0.05)。术后,PSE治疗组TNF-α、IL-6、IL-18水平低于全切治疗组;PSE治疗组门静脉内径、流速、门脉压力均低于全切治疗组;PSE治疗组患者的手术用时、术中出血量、住院时间均低于全切治疗组(P<0.05);PCE治疗组PT、APTT水平高于全切治疗组(P<0.05);PSE治疗组患者术后并发症发生率低于全切治疗组,差异有统计学意义(P<0.05)。结论肝硬化脾功能亢进患者接受部分脾栓塞术治疗后,其血流动力学指标、凝血功能及炎症因子水平均可得到有效改善,手术时间和住院时间更少,术后并发症的发生率更低,效果和安全性得以保障。Objective To study and analyze the effects of partial splenic embolization on inflammation and coagulation in patients with cirrhosis and hypersplenism.Methods 78 patients with portal hypertension and hypersplenism who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2022 to February 2023 were randomly assigned into two groups:the complete splenectomy group(undergoing total splenectomy)and the PSE treatment group(undergoing partial splenic embolization),with 39 patients in each group.The preoperative and postoperative levels of inflammatory factors,hemodynamic indicators,coagulation function levels,intraoperative indicators,length of hospital stay,and incidence of complications were evaluated in both groups.Results Preoperatively,there were no statistically significant results when comparing the levels of various inflammatory factors,hemodynamic indexes,and coagulation levels between groups(P>0.05);postoperatively,the portal vein internal diameter,flow rate,and portal pressure of patients in the PSE treatment group were lower than those in the total excision treatment group(P<0.05);and the levels of TNF-α,IL-6,and IL-18 in the PSE treatment group were lower than those in the total excision treatment group(P<0.05);The operative time,intraoperative bleeding,and total hospital stay of patients in the PSE treatment group were lower than those in the total excision treatment group(P<0.05);The levels of PT and APTT in PCE group were higher than those in total resection group(P<0.05);and the complication rate of patients in the PSE treatment group was lower than that in the total excision treatment group(P<0.05).Conclusions partial splenic embolization can significantly improve postoperative hemodynamic indexes,inflammatory factor levels,and coagulation function in patients with cirrhosis and hypersplenism.The operative time and hospital stay are less,and the incidence of postoperative complications is lower,so the efficacy and safety can be guaranteed.

关 键 词：部分脾栓塞术 肝硬化 脾功能亢进 炎症反应 凝血功能 

分 类 号：R551.1[医药卫生—血液循环系统疾病]