手术治疗肝豆状核变性并脾功能亢进的疗效评价

Evaluation of therapeutic efficacy on hepatolenticular degeneration complicated with hypersplenism by surgical treatment

目的评价脾切除术联合胃底贲门周围血管离断术治疗肝豆状核变性并脾功能亢进的疗效。方法 148例肝豆状核变性并脾功能亢进患者行脾切除术联合胃底贲门周围血管离断术治疗,检测患者的血常规、肝功能变化,评定手术疗效。结果手术后1周,患者血小板(PLT)、白细胞(WBC)较手术前显著升高(P<0.05),甚至超过正常范围;手术后1月的PLT、WBC水平则显著回落,恢复正常水平。谷丙转氨酶、谷草转氨酶、总胆红素术前处于较高水平,术后1周较术前进一步升高(P<0.05),而术后1月时其水平较术前及术后1周均有显著下降(P<0.05)。结论脾切除术联合胃底贲门周围血管离断术治疗肝豆状核变性并脾亢,对恢复外周血细胞数量、保护肝功能均有显著作用。

Objective To evaluate the therapeutic efficacy of hepatolenticular degeneration complicated with hypersplenism treated by splenectomy combined with disarticulation of cardiac peripheral vessels.Methods A hundred and forty-eight patients with hepatolen-ticular degeneration complicated with hypersplenism treated by splenectomy combined with disarticulation of cardiac peripheral vessels took routine blood and liver function tests to evaluate the surgical treatment.Results One week after surgery,the amount of PLT and WBC significantly increased,higher than before operation （P 〈0.05）,even beyond the normal range.One month after surgery,the a-mount of PLT and WBC significantly decreased to normal range.The level of ALT,AST and TBil stay high before operation,even higher 1 week after operation（P 〈0.05）,yet it was significantly decreased in 1 month after operation compared with before and 1 week after operation.Conclusions There is significant effect on decreasing the amount of peripheral blood cells and protect the liver function by the treatment of hepatolenticular degeneration complicated with hypersplenism by splenectomy combined with disarticulation of cardiac peripheral vessels.