腹腔镜下脾切除联合静脉断流治疗肝硬化门脉高压的临床研究

Clinical Study on Laparoscopic Splenectomy Combined With Venous Devascularization in the Treatment of Liver Cirrhosis With Portal Hypertension

目的研究分析肝硬化门脉高压患者接受腹腔镜下脾切除联合静脉断流和介入栓塞治疗的临床效果。方法选取我院收治的64例肝门硬化门脉高压患者作为研究对象,将其随机分成对照组和观察组,每组均32例。对照组采用介入栓塞治疗,观察组采用腹腔镜下脾切除联合静脉断流,对两组治疗前后的效果以及血细胞、肝功能指标进行比较。结果治疗后,观察组的治疗总有效率为93.75%,对照组为75.00%,组间对比,差异具有统计学意义(P<0.05);治疗后,两组患者血细胞和肝功能指标均优于治疗前,且观察组优于对照组(P<0.05)。治疗后,观察组白细胞计数为(9.53±2.99)×10~9/L、血小板计数(272.38±80.31)×10~9/L、红细胞计数(6.13±1.80)×10^(12)/L;对照组为(8.02±2.58)×10~9/L、(168.43±50.64)×10~9/L、(5.22±1.81)×10^(12)/L,观察组均优于对照组,差异具有统计学意义(P<0.05)。结论肝硬化门脉高压使用腹腔镜下脾切除联合静脉断流治疗效果比介入栓塞优秀。

Objective To study the clinical effect of laparosenpic splenectomy combined with pericardial devascularization and interventional embolization in patients with portal hypertension of liver cirrhosis. Methods According to the analysis of the 64-mile portal hypertension patients received in our hospital divided into the control group and observation group, 32 cases in each group. The control group was treated with interventional embolization, the observation group was trented with laparosenpic splen-omy combined with venous disconnection, the effect of two groups before and afl- tteattnent, and the indexes of blood cells and liver function were compared. Results After treatment, the effective rate was 93.75 % in the observation group and 75.00 % in the control group （P〈0.05）. Two groups of blood cells and liver function index after treatment were better than before treatment, the observation group was better than the control group （P〈0.05）.After treatment, the white blood cells of the observation group were （9.53±2.99）×10^9/L, platelet count （272.38±80.31）×10^9/L, red blood cell count （6.13±1.80）×10^12/L. The control group was （8.02±2.58）×10^9/L, （168.43±50.64 ）×10^9/L, （5.22±1.81）×10^12/L, the observation group was better than the control group （P〈0.05）. Conclusion The effect of laparoscopic splenectomy combined with venous devascularization is superior to interventional embolization in the treatment of cirrhosis with portal hypertension.