肝硬化患者脾功能亢进治疗研究进展

Progress in treatment of hypersplenism in patients with post-hepatitis cirrhosis

脾功能亢进是肝炎肝硬化的常见并发症,然而,并非所有脾功能亢进均需要治疗。临床上如果不能确定纠正脾功能亢进对患者有益,就不进行脾脏处理。但仍有部分脾功能亢进患者因各种原因需要进行脾脏处理,介绍了脾功能亢进的治疗方法的最新进展,包括脾切除术、脾动脉栓塞术、脾脏射频消融术、肝移植、药物治疗及经颈静脉肝内门体静脉分流术等;认为上述方法各有利弊,目前临床上更倾向于微创治疗脾功能亢进,但其临床应用时间尚短,仍需要技术上的提高及更多的循证医学证据来支持使其逐渐规范化。

Hypersplenism is a common complication of post - hepatitis cirrhosis, and may not need to be treated. The treatment of hypersplenism is not considered if it is not proven clinically beneficial to patients. However, there are still some patients with hypersplenism who should be treated for some reasons. This article reviews the latest progress in the therapies for hypersplenism, including splenectomy, splenic artery embolization, splenic radiofrequency ablation, liver transplantation, medication, and transjugular intrahepatic portosystemic shunt. It is demonstrated that all the above treatments have advantages and disadvantages. Minimally invasive methods, through currently preferred for hypersplenism, have not yet been clinically applied for a long period, and remain to be technically improved and supported by relevant evidence for standardization.