失代偿肝硬化合并胆囊结石的自体骨髓肝内输注治疗

Autologous bone marrow transfusion for the treatment of gallbladder calculus with decompensated liver cirrhosis

目的研究自体骨髓经门静脉肝内输注对失代偿期肝硬化合并胆囊结石患者的疗效。方法观察18例失代偿期肝硬化合并胆囊结石患者,其中4例采用单纯腹腔镜胆囊切除手术;14例采用脾切除加自体骨髓经门静脉输注治疗。结果 4例单纯胆囊切除手术患者术中出血多,术后1年肝功能没有改善。14例脾切除加自体骨髓经门静脉输注治疗者,术后3个月肝功能基本恢复正常,其中4例脾切除手术时切除胆囊患者,术中出血多;3例1年后再次手术切除胆囊患者,手术顺利。7例患者没有切除胆囊,无明显临床症状。结论自体骨髓经门静脉输注治疗可以促进失代偿期肝硬化患者肝功能重建,肝功能好转后再次手术胆囊切除可以降低手术风险。

Objective To investigate the therapeutic effect of splenectomy and bone marrow transfusion （BMT） for the patients of decompensated liver cirrhosis with gallbladder calculus. Methods Sample cholecystectomy were performed in 4 patients, splenectomy and BMT were performed in 14 gallbladder calculus patients with decompensated liver cirrhosis. Cholecystectomy were also performed in 4 patients during splenectomy. Three patients were performed cholecystectomy one year after splenectomy and BMT. Results There were huge volume bleeding during operation of sample cholecystectomy in 4 patients and no change of liver function one year after operation was found. The liver function restored after splenectomy and BMT in 14 patients. There was also huge volume bleeding in 4 patients during splenectomy and cholecystectomy. The operation were unevent- fully in 3 patients who were performed cholecystectomy one year after splenectomy and BMT. Conelussion Splenectomy and BMT for the gallbladder calculus patient with decompensated liver cirrhosis can promote liver function reconstrauction. The cholecystectomy is safety for the patient with deeompensated liver cirrhosis one year after splenectomy and BMT.