探讨TIPS联合PSE对肝硬化门脉高压伴脾亢患者血流动力学及免疫功能的影响

发布时间：2018-05-21 11:15

  本文选题：门脉高压 + 脾功能亢进　； 参考：《青海大学》2017年硕士论文

【摘要】：目的:探讨TIPS联合PSE对肝硬化门脉高压合并脾亢患者门脉血流动力学改变及机体免疫调节的影响。方法:所有入选66例病例,均通过入组标准及排除标准遴选,半随机分为两组,其中TIPS+PSE组36例,TIPS组30例。观察指标分别为术前、术后7d、30d患者门静脉流速及直径、分流道流速、外周血象、T细胞亚群、体液免疫功能指标。结果:TIPS+PSE组与TIPS组比较:术后30d分流道流速、门脉主干流速、门脉主干直径无统计学差异(P0.05);TIPS+PSE组与TIPS组血WBC比较:术后7d及术后30d具有统计学差异(P0.05),TIPS+PSE组,术后1d、7d、30d与术前比较具有统计学差异(P0.05);TIPS+PSE组与TIPS组PLT比较:术后7d及术后30d具有统计学差异(P0.05),TIPS+PSE组术后7d、30d与术前对照差异具有显著性(P0.05)。TIPS+PSE组与TIPS组CD3、CD4、CD8、CD4/CD8比较:术后7d及术后30d具有统计学差异(P0.05),TIPS+PSE组CD3、CD4、CD8、CD4/CD8术后7d及术后30d与术前比较具有统计学差异(P0.05)。TIPS+PSE组与TIPS组IgA、IgM、IgG比较:术后30d具有统计学差异(P0.05),TIPS+PSE组IgA、IgM、IgG术后30d与术前1d比较具有统计学差异(P0.05)。TIPS+PSE组与TIPS组术后并发症比较均无统计学差异(P0.05)。结论:TIPS联合PSE治疗肝硬化门脉高压合并脾亢,创伤小,安全性高,改善了门静脉血流,有效缓解患者脾功能亢进症状、提高外周血白细胞及血小板水平、改善机体细胞及体液免疫功能。
[Abstract]:Objective: to investigate the effect of TIPS combined with PSE on portal hemodynamics and immune regulation in patients with cirrhosis and portal hypertension complicated with hypersplenism. Methods: all 66 cases were randomly divided into two groups, including 36 cases in TIPS PSE group and 30 cases in Tips group. The parameters were portal vein velocity and diameter, shunt velocity, peripheral blood T cell subsets and humoral immune function. Results compared with TIPS group, there was no significant difference in shunt velocity and portal trunk diameter between PSE group and TIPS group 30 days after operation. There was no significant difference in the diameter of portal trunk between PSE group and TIPS group. There was a significant difference in WBC between PSE group and TIPS group on the 7th day after operation and 30 day after operation. There was significant difference in PLT between the PSE group and the TIPS group on the 1st day and the 7th day after operation. There was a significant difference between the 7 days after operation and the 30 days after the operation. There was a significant difference between the PSE group and the TIPS group on the CD3 CD4CD _ 4 ~ (8) CD _ 4 / CD _ 8: 7 days after the operation, there was a significant difference between the three groups (P < 0.05) and the control group (P < 0.05). There was a significant difference between the PSE group and the TIPS group in terms of CD4 / CD _ 8: 7 days after the operation, there was a significant difference between the PSE group and the TIPS group. There was statistical difference between the 30 days after operation and the 30 days after operation. There was statistical difference between the three groups (P0.05TIPS PSE group) on the 7th day after the operation and the 30 days after the operation compared with the preoperative group. There was a statistical difference between the PSE group and the TIPS group on the 30th day after the operation. There was a statistical difference between the 30 days after the operation and the 1d before operation in the group of P0.05TIPS PSE. There was no significant difference in postoperative complications between the tips PSE group and the TIPS group. Conclusion the treatment of liver cirrhosis with portal hypertension with hypersplenism combined with PSE has little trauma and high safety. It can improve the portal vein blood flow, relieve the symptoms of hypersplenism, and increase the level of peripheral blood leukocytes and platelets. Improve cellular and humoral immune function.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R575.2

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