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目的探讨脾动脉主干截流术对肝硬化患者脾动脉盗血综合征的治疗效果。方法 86例肝硬化合并有脾动脉盗血综合征患者作为研究对象,其中2012年1月~2014年5月收治的36例肝硬化患者为观察组,2008年12月~2011年12月收治的50例肝硬化住院患者为对照组。观察组采用脾动脉主干截流术;对照组采用脾脏部分动脉栓塞术。术后均随访12个月,比较两组术后12个月生存率、肝功能分级和肝脏容积等数据的改变情况。结果术后12个月观察组生存率为100.00%(36/36),对照组生存率为88.00%(44/50),两组生存率比较差异有统计学意义(P<0.05)。术后12个月观测肝功能分级变化,观察组A~B级33例、C级3例(8.33%);对照组A~B级37例、C级13例(26.00%),两组肝功能分级情况比较差异有统计学意义(P<0.05)。观察组治疗后肝脏容积较治疗前和对照组治疗后均显著增加,差异有统计学意义(P<0.05)。术后观察组有5例不良事件,发生率13.89%,而对照组有19例,发生率为38.00%,两组差异有统计学意义(P<0.05)。结论肝硬化患者进行血管介入脾动脉主干截流术治疗,能减轻脾动脉盗血,延缓肝功能恶化,减轻脾功能亢进,并发症少,值得临床推广。
Objective To investigate the therapeutic effect of splenic artery steal syndrome on patients with liver cirrhosis. Methods A total of 86 patients with cirrhosis complicated with splenic artery steal syndrome were enrolled. Among them, 36 patients with cirrhosis who were treated from January 2012 to May 2014 were selected as the observation group, December 2008 ~ December 2011 50 cases of cirrhosis hospitalized patients as control group. The observation group was treated with splenic artery occlusion. The control group was treated with splenic partial arterial embolization. The patients were followed up for 12 months. The changes of survival rate, liver function classification and liver volume were compared between the two groups at 12 months after operation. Results The survival rate of the observation group was 100.00% (36/36) at 12 months after operation. The survival rate of the control group was 88.00% (44/50). There was significant difference between the two groups in survival rate (P <0.05). In the observation group, 33 cases were grade A ~ B and 3 cases were grade C (8.33%) in the observation group. The control group had 37 cases of grade A ~ B and 13 cases (26.00%) of grade C, Functional grading was significantly different (P <0.05). The liver volume of observation group after treatment was significantly higher than that before treatment and control group after treatment, the difference was statistically significant (P <0.05). There were 5 cases of adverse events in the postoperative observation group, the incidence rate was 13.89%, while the control group, 19 cases, the incidence was 38.00%, the difference between the two groups was statistically significant (P <0.05). Conclusions The treatment of hepatic cirrhosis by vascular intervention of the splenic artery can reduce the steal of the splenic artery, delay the deterioration of hepatic function, reduce the hypersplenism, and has fewer complications. It is worthy of clinical promotion.