肝硬化患者脾脏切除及断流术对肝功能的影响分析

目的研究肝硬化患者治疗中脾脏切除及断流术对肝功能的影响。方法选取2012年3月至2016年1月就诊的共126例肝硬化患者作为观察对象。将其根据治疗方法不同分为对照组（n=61例）和观察组（n=65例）。其中对照组患者采用药物治疗，观察组患者采用脾脏切除及门脉断流术，比较两组患者治疗前后的肝功能和血常规结果及复发率。结果观察组患者治疗后凝血酶原活动度、血小板计数及白细胞计数明显高于对照组，白蛋白明显低于对照组，且差异均有统计学意义（P〉0．05），两组患者凝血酶原活动度、白蛋白、血小板计数及白细胞计数与治疗前比较有显著性差异（P〈0．05）。两组患者治疗前CD4＋，CD8＋，CD4＋／CD8＋及cRP等无显著性差异（P〉0．05）．观察组患者治疗后CD4＋、CD4＋／CD8＋均高于对照组，CD8＋、CRP均明显低于对照组，两组患者的CD4＋、CD4＋／CD8＋较治疗前均明显降低，CD8＋、CRP较治疗前均明显增高，且差异均有统计学意义（P〈0.05）。对照组患者复发率为27．87％，明显低于观察组复发率4.62％（P〈0．05）。结论肝硬化患者治疗中，脾脏切除联合断流术有确切治疗效果，复发率低，值得临床推广。

Objective To research the liver function of splenectomy and devasculatization in the treatment of hepatocirrhosis. Methods 126 hepatocirrhosis cases were selected as objects between March 2012 and January 2016 in our hospital and divided into two groups, called control group （ n=61 cases ） and research group （ n=65 cases ） by different treatment, the control group patients were treated by double interventional embolization, while research group patients were treated by splenectomy and devasculatization method. The pre-treatment and post-treatment liver function and routine blood test and recurrence rate of two groups were compared. Results The post-treatment PTA, platelet count and leukocyte count of research group were higher than control group, albumin was less than control group （ P〈0.05 ） , the post-treatment PTA, platelet count and leukocyte of two groups had statistical difference with pre-treatment （ P〈0.05 ） . The recurrence rate of control group was 27.87%, less than 4.62% of research group （ P〈0.05 ） . Conclusion In the treatment of hepatocirrhosis, splenectomy and devasculatization has exact therapeutic effect, low recurrence rate, and worthy of clinical promotion.