脾栓塞联合拉米夫定治疗乙肝肝硬化并脾功能亢进的临床研究

Clinical study of splenic embolization combined with lamivudine in the treatment of hepatitis B hepatocirrhosis and hypersplenism

目的探讨和评价部分脾栓塞术联合拉米夫定治疗乙肝后肝硬化脾功能亢进的临床应用价值及远期治疗效果。方法将84例乙肝后肝硬化脾功能亢进的患者随机分为三组，联合治疗组、脾栓塞组及拉米夫定组，每组28例。联合治疗组在脾栓塞的基础上同时给予拉米夫定100mg／d口服，连续治疗18个月；脾栓塞组为单纯进行脾动脉栓塞，方法同联合治疗组；拉米夫定组为单纯口服拉米夫定，剂量时间同联合治疗组。结果联合治疗组治疗肝硬化脾功能亢进明显优于脾栓塞组和拉米夫定组（P〈0．05）。结论部分脾栓塞术联合拉米夫定治疗乙肝后肝硬化脾功能亢进可明显阻止疾病进展，减少并发症，长期稳定患者肝功能并提高生存质量。

Objective To investigate and evaluate the clinical application value and long-term therapeutic effect of splenic embolization combined with lamivudine on hepatitis B hepatocirrhosis and hy- persplenism. Methods Eighty-four cases of hepatitis B hepatoeirrhosis and hypersplenism were random- ly divided into three groups, combined treatment group, splenic embolization group and lamivudine group, 28 cases in each group, patients in combined treatment group were given lamivudine （ 100 mg/d） for 18 months on the basement of splenic embolization, patients in splenic embolization group were only given splenic embolization, the way was same to combined treatment group, patients in lamivudine group were only given lamivndine, the way was same to combined treatment group. Results The effect of com- bined treatment group was significantly superior to splenic embolization group and lamivudine group （P 〈 0. 05 ）. Conclusions Splenic embolization combined with lamivudine can prevent the progress of the disease, reduce the complications, keep long-term liver function stability and improve living quality.