保脾断流术治疗老年肝硬化门静脉高压患者的疗效

发布时间：2019-02-16 03:53

【摘要】：目的探讨保脾断流术治疗老年肝硬化门静脉高压患者的效果。方法选取老年肝硬化门静脉高压患者56例,依据手术方案分为保脾组(保脾断流术)和对照组(全脾切除断流术),比较两组患者的术中术后情况、免疫功能和术后并发症。结果保脾组患者的手术时间、术中出血量和住院时间均明显低于对照组(P0.05)。术前两组患者的CD4~+、CD8~+、CD4~+/CD8~+无显著差异(P0.05)。术后保脾组患者的CD4~+、CD4~+/CD8~+明显高于对照组(P0.05),两组患者的CD8~+无显著差异(P0.05)。保脾组术后并发症总发生率为16.00%,明显低于对照组(25.81%,P0.05)。结论保脾断流术治疗老年肝硬化门静脉高压患者,能够明显缩短手术时间,维持患者免疫功能,有效预防门静脉血栓形成,值得临床推广。
[Abstract]:Objective to investigate the effect of splenic preservation and devascularization in elderly patients with portal hypertension. Methods Fifty-six elderly patients with portal hypertension of liver cirrhosis were divided into two groups according to the operation plan: splenic preservation group (preservation of splenic devascularization) and control group (total splenectomy and devascularization). The intraoperative and postoperative conditions, immune function and postoperative complications were compared between the two groups. Results the operative time, intraoperative blood loss and hospital stay in the spleen preserving group were significantly lower than those in the control group (P0.05). There was no significant difference in CD4~, CD8~, CD4~ / CD8~ between the two groups before operation (P0.05). The CD4~, CD4~ / CD8~ in the spleen preserving group were significantly higher than those in the control group (P0.05), and there was no significant difference in CD8~ between the two groups (P0.05). The total incidence of postoperative complications in the spleen preserving group was 16.00, which was significantly lower than that in the control group (25.81% P 0.05). Conclusion the operation time can be shortened obviously, the immune function can be maintained and the portal vein thrombosis can be effectively prevented by splenic preservation and disconnection in elderly patients with cirrhosis and portal hypertension, which is worth popularizing in clinic.
【作者单位】：济南市第三人民医院肝胆血管外科;济南市第三人民医院内镜中心;济南市第三人民医院普外科;
【分类号】：R657.34

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