门脉高压症腹膜后自体单个核细胞移植治疗后门静脉压力变化的临床研究

Clinical Study on change of portal pressure after retroperitoneal autologous bone marrow mononuclear cells autotransplantation in the treatment of portal hypertension

目的探讨肝炎后肝硬化门脉高压症腹膜后单个核细胞移植对门静脉压力的影响。方法随机对肝炎后肝硬化并门静脉高压症上消化道出血的70例病人分为治疗组和对照组。治疗组36例病人行脾切除、门—奇静脉断流的同时在腹膜后植入自体骨髓单个有核细胞。对照组34例行脾切除、门—奇静脉断流。观察术后再出血率及门静脉压力变化情况,用SAS统计软件分析处理。结果 36例在手术后12个月测门静脉压力降低,随访5a无再出血病例。结论肝硬变并门静脉高压症上消化道出血病人在行脾切除,门-奇断流的同时,在腹膜后植入自体骨髓单个核细胞可以增加门静脉侧支循环,降低门静脉压力,预防再上消化道出血的发生。

Objective To explore the effect of retroperitoneal autologous bone marrow mononuclear cells auto transplantation in the treatment of posthepatitic cirrhosis induced portal hypertension. Methods The 70 posthepatitic cirrhosis induced portal hypertension patients with upper gastrointestinal hemorrhage were randomly divided into treatment group and control group. In the treatment group, retroperitoneal autologous bone marrow mononuclear cells autotransplantation with splenectomy and portoazygous devascularization were performed in 36 patients,while in the control group,splenectomy and portoazygous devascularization were conducted in 34 patients.Compared the regeneration of change of portal pressure and postoperative rebleeding. Results after the following 18months,portal pressure were cut down ,rebleeding cases were superior to the control group after the following 5 years. Conclusion In the posthepatitic cirrhosis induced portal hypertension patients with upper gastrointestinal hemorrhage,combinatin therapy of retroperitoneal autologous bone marrow mononuclear cells autotransplantation with splenectomy and portoazygous devascularization could reduce portal pressure, prevent rebleeding.