糖皮质激素与解热镇痛药治疗脾动脉栓塞术后综合征的效果对比分析

Curative effect analysis of glucocorticoid and anti-inflammatory drug treatment of postoperatively syndrome after splenic artery embolization

目的 分析糖皮质激素及解热镇痛药治疗脾动脉栓塞术后综合征的效果。方法 选择2010年4月～2013年6月本院接诊的50例肝硬化合并脾功能亢进。部分脾动脉栓塞术后综合征的患者进行研究，按照随机数表法将其随机均分为观察组和对照组。观察组患者给予糖皮质激素（地塞米松）治疗，对照组采用解热镇痛药治疗。观察两组患者术后7d的外周血白细胞（WBC）、总胆红素（TBiL）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、血白蛋白（Alb）的变化情况及患者的腹痛时间、发热时间及住院时间。结果 两组患者术后经治疗后WBC水平均明显升高（P〈0．05），Alb均明显下降（P〈0．05）；观察组患者术后经治疗后，WBC水平明显高于对照组（P〈0．05）。观察组患者的腹痛时间、发热时间及住院时间均明显短于对照组，两组差异有统计学意义（P〈0．05）。两组患者均出现不同程度的发热、腹痛等术后综合征，但是所有患者均未出现静脉血栓、脾脓肿等严重并发症。结论 采用糖皮质激素治疗脾动脉栓塞术后综合征，可显著改善患者术后炎症状况，效果良好，值得临床推广应用。

Objective To analyze the therapeutic efficacy of glucocorticoid and anti-inflammatory drug treatment of postoperatively syndrome after splenic artery embolization. Methods 50 cases of liver cirrhosis with hypersplenism,partial splenic artery embolization syndrome after operation were researched in our hospital from April 2010 to June 2013. According to a random number table method,they were randomly divided into observation group and control group.The observation group was treated with glucocorticoids （dexamethasone）,the control group were treated with antipyretic analgesics.The changes of peripheral blood leukocytes （WBC）,total bilirubin （TBiL）,alauine aminotransferase （ALT）,aspartate aminotransferase （AST）,serum albumin （Alb） and the patient＇s abdominal pain time,heating time,and length of stay in two groups after operation 7 d were recorded. Results After treatment,the WBC levels in both groups were sig- nificantly higher （P〈0.05）,Alb were significantly decreased （P〈0.05）,observation group of patients after treatment,the WBC level obviously was higher than that of the control group （P〈0.05）.Observation group of patients with abdominal pain,fever time and hospital stay were significantly shorter than those of the control group,the differences between the two groups was statistically significant （P〈0.05）.Two groups of patients were different degree of postoperative syndrome such as fever,abdominal pain,but all of the patients did not appear vein thrombosis,splenic abscess and other serious complications. Conclusion Glucocorticoid treatment of postoperatively syndrome after splenic artery embolization can significantly improve postoperative inflammatory conditions,the effect is good,it is worthy of clinical application .