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目的:分析脾切除术对肝炎后肝硬化患者发生肝癌的影响。方法:随机选择泰州市人民医院2013年2月至2015年2月收治的肝炎后肝硬化患者500例,其中340例患者行脾切除术为观察组,其余160例患者未接受脾切除术作为对照组,回顾性分析两组患者临床资料。结果:观察组患者手术前肝动脉血流量(HAF)、门静脉血流量(PVF)、自由门静脉压力(FPP)为(415±65)m L/min、(1369±401)m L/min、(30±8)cm H2O,手术后(528±140)m L/min、(984±276)m L/min、(25±5)cm H2O,差异具有统计学意义(P<0.05);手术前后患者天冬氨酸转氨酶(AST)、白细胞计数(WBC)、血小板计数(PLT)、总蛋白(TP)、碱性磷酸酶(ALP)比较,差异具有统计学意义(P<0.05),手术前后凝血酶原时间(PT)、红细胞计数(RBC)、谷丙转氨酶(ALT)、谷酰转氨酶(GGT)、白蛋白(ALB)、总胆红素(TBIL)差异均无统计学意义(P>0.05)。观察组患者肝癌发生率为10.88%,明显低于对照组25.00%(P<0.05)。结论:肝炎后肝硬化患者接受脾切除术,可有效改善患者肝功能,减少肝癌发生风险,提高患者生活质量。
Objective: To analyze the effect of splenectomy on hepatocellular carcinoma in patients with posthepatitic cirrhosis. Methods: 500 patients with posthepatitic cirrhosis were randomly selected from Taizhou People’s Hospital from February 2013 to February 2015. 340 patients underwent splenectomy as the observation group, and the other 160 patients did not receive splenectomy as control Group, retrospective analysis of two groups of patients clinical data. Results: The preoperative hepatic arterial blood flow (HAF), portal vein blood flow (PVF) and free portal pressure (FPP) in the observation group were (415 ± 65) m L / min and (1369 ± 401) m L / The difference was statistically significant (P <0.05) before and after surgery (P <0.05), and the difference was statistically significant (P <0.05) The difference of AST, WBC, PLT, TP and ALP between the two groups was statistically significant (P <0.05). Before and after operation There was no significant difference in PT, RBC, ALT, GGT, ALB, TBIL between the two groups (P> 0.05). The incidence of liver cancer in the observation group was 10.88%, which was significantly lower than that in the control group (25.00%, P <0.05). Conclusion: Patients with posthepatitic cirrhosis receiving splenectomy can effectively improve the liver function, reduce the risk of liver cancer and improve the quality of life of patients.