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目的 探讨肝脾联合切除术治疗肝癌合并肝硬化脾功能亢进的远期疗效。方法 对1 0 2例肝癌合并肝硬化脾功能亢进患者的临床资料进行回顾性分析。 5 7例行肝脾联合切除术 (A组 ) ,4 5例行单纯肝切除术 (B组 )。结果 A、B两组术中出血及术后并发症的发生率差异均无显著意义 (P >0 0 5 ) ,但术后血小板、白细胞的回升及与肝硬化预后相关的指标谷氨酰转肽酶 (GGT)数值的改善 ,A组明显好于B组 (P <0 0 5 )。两组 1、3、5年复发率分别为 2 7 1 %、4 8 6 %、6 9 3%及4 1 2 %、5 0 0 %、77 9% ;生存率分别为 92 6 %、5 9 1 %、4 1 8%及 80 3%、4 3 9%、2 9 1 % ,两组虽然没有统计学差异 ,但A组的生存情况均好于B组 ,而且A组复发患者的平均带瘤生存期 (1 2 9个月 )亦明显长于B组 (6 3个月 ,P <0 0 1 )。结论 肝脾联合切除术治疗肝癌合并肝硬化脾功能亢进不但具有良好的安全性且长期随访的结果是满意的
Objective To investigate the long-term curative effect of hepatosplenomegaly resection on hepatocellular carcinoma with liver cirrhosis and hypersplenism. Methods The clinical data of 102 patients with liver cancer complicated with liver cirrhosis and hypersplenism were analyzed retrospectively. Fifty-seven patients underwent combined hepatectomy and splenectomy (group A) and 45 patients underwent simple hepatectomy (group B). Results The incidence of intraoperative bleeding and postoperative complications in groups A and B were not significantly different (P> 0.05), but the postoperative recovery of platelets and white blood cells and the indexes related to the prognosis of liver cirrhosis Peptidase (GGT) values improved significantly in group A than in group B (P <0.05). The recurrence rates at 1, 3 and 5 years were 271%, 486%, 693% and 41 2%, 50% and 77 9%, respectively; the survival rates were 92.6% and 5% 9 1%, 41 8% and 80 3%, 49 3% and 291% respectively. Although there was no statistical difference between the two groups, the survival of group A was better than that of group B, and the average of patients in group A Tumor survival (119 months) was also significantly longer than the B group (63 months, P <0.01). Conclusions Hepatic and splenic combined resection of liver cancer with cirrhosis and hypersplenism not only has good safety and long-term follow-up results are satisfactory