门脉断流术联合脾脏切除术治疗肝硬化门脉高压症的临床疗效

Clinical Effect of Portal Vein Devascularization Combined with Splenectomy for Cirrhotic Portal Hypertension

目的评价门脉断流术联合脾脏切除术治疗肝硬化门脉高压症患者的临床疗效。方法选取重庆市长寿区人民医院2014年7月至2019年7月收治的肝硬化门脉高压症患者60例,按手术方式分为观察组与对照组,各30例。对照组患者通过经皮穿刺肝胃食道静脉栓塞术和部分脾栓塞术进行联合治疗,观察组患者则通过门脉断流术联合脾脏切除术进行治疗。对2组患者的治疗后的血细胞计数水平(血小板计数、白细胞计数、红细胞计数)和肝功能(凝血酶原活动度、丙氨酸转氨酶、总胆红素、白蛋白)进行比较。结果观察组患者治疗后的血小板及白细胞计数水平、凝血酶原活动度明显高于对照组,白蛋白水平明显低于对照组,差异均有统计学意义(P<0.05)。结论肝硬化门脉高压症患者通过门脉断流术联合脾脏切除术治疗,治疗效果显著,血细胞计数水平和肝功能得到明显改善。

Objective To evaluate the clinical effect of portal vein devascularization combined with splenectomy on patients with cirrhotic portal hypertension.Methods From July 2014 to July 2019,60 patients with cirrhotic portal hypertension admitted to Chongqing Changshou District People's Hospital were selected and randomLy divided into an observation group and a control group,30 cases per group.The patients in the control group were treated with transcutaneous transhepatic gastroesophageal vein embolization and partial splenic embolization.The patients in the observation group were treated with portal vein devascularization combined with splenectomy.The blood cell count(platelet count,white blood cell count,red cell count)and liver function(prothrombin activity,alanine aminotransferase,total bilirubin,albumin)were compared between the two groups.Results After treatment,the platelet and white blood cell count levels and prothrombin activity of patients in the observation group were significantly higher than those in the control group,and the albumin levels were significantly lower than those in the control group,with statistically significant differences(all P<0.05).Conclusion The treatment of portal vein devascularization combined with splenectomy for patients with cirrhotic portal hypertension had significant therapeutic effects and significant improvement in blood count levels and liver function.