| 摘要: |
| ［摘要］ 目的 探讨原发性肝癌合并肝硬化门静脉高压并脾功能亢进患者手术方式及病例选择对手术效果及安全性的影响。方法 对2005-05～2011-11我院收治的60例肝癌合并肝硬化门静脉高压并脾功能亢进行手术治疗患者的临床资料进行回顾性分析。观察组30例应用食管横断法门奇静脉断流术联合肝脾切除术，对照组30例单纯行肝癌切除术。比较两组肝功能分级、肝硬化程度、术前与术后血常规及肝功能变化、术后并发症等指标，判断手术安全性及病例选择对手术效果的影响。结果 60例患者随访5个月～5年，平均（12.3±2）个月，观察组治愈20例，总有效率为96.7%，复发率为16.7%；对照组治愈15例，总有效率为80%，复发率为30.0%，两组差异无统计学意义（P>0.05）。对照组术前术后血小板、白细胞变化无明显差异。观察组术后血小板、白细胞较术前明显升高(P<0.01)。观察组和对照组术后5年无瘤生存分别为10例（33.3%）和5例（16.7%），差异有统计学意义(P<0.05)。结论 原发性肝癌合并肝硬化门静脉高压并脾功能亢进患者同期行食管横断法门奇静脉断流术联合肝脾切除术是可行的。 |
| 关键词: 原发性肝癌 肝硬化 脾功能亢进 肝脾切除术 |
| DOI：10.3969/j.issn.1674-3806.2012.06.04 |
| 分类号:R 735.7 |
| 基金项目:广西区卫生厅科研课题（编号：Z2011041） |
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| Clinical research on esophageal transection portal- azygos disconnection combined with liver and spleen resection in the treatment of patients with primary hepatocellular carcinoma associated with hypersplenism |
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LAO Jing-mao
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Department of General Surgery, the People′s Hospital of Lingshan County,Guangxi 535400,China
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| Abstract: |
| ［Abstract］ Objective To investigate the impact of surgical method on judging the operative safety and the impact of patient selection on the effect of surgery in patients with primary hepatocellular carcinoma associaled with portal hypertension and hypersplenism.Methods Clinical data of 60 patients with primary hepatocellular carcinoma associated with portal hypertension and hypersplenism treated in our hospital from May 2005 to Novenber 2011 were retrospectively analyzed, including 30 patients treated by the esophagus transection portal- azygos disconnection combined with liver and spleen resection, 30 patients treated by simple liver resection. Between two groups the liver function, the degree of cirrhosis, preoperative and postoperative changes in blood and liver function, postoperative complications, and other indicators were compared, for determining the safety of surgery and the impact of patient selection on surgical effect.Results Sixty patients were followed up for 5 months to 5 years,with the average of (12.3 ± 2)months, In the treatment group 20 cases were cured, total effective rate was 96.7%, recurrence rate was 16.7%;in control group were 15 cases, total effective rate was 80.0%, the recurrence rate was 30.0%(P <0.05),in control group, there was no significant difference in preoperative and postoperative platelet and WBC; in treatment group, platelets and WBC after treatment was significantly higher than that before treatment. 5-year disease-free survival after the treatment in the treatment group and control groups were 10 cases (33.3%) and 5 casese (16.7%) respatively, the difference was significant (P <0.05).Conclusion For patients with primary hepatocellular carcinoma associaled with portal hypertension and hypersplenism, concomitant esophageal transection patal- azygos disconnection combined with resection of the liver and spleen is feasible. |
| Key words: Primary liver carcinoma Cirrhosis Hypersplenism Liver and spleen resection |
