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目的:探讨肝癌合并肝硬化脾功能亢进患者行肝癌联合脾脏切除术与单纯肝癌切除术的临床疗效。方法:55例肝癌合并肝硬化脾功能亢进患者中,25例行肝癌联合脾切除,30例行单纯肝癌切除,对两种术式术后并发症、肝功能及血常规进行比较和分析。结果:单纯肝癌切除组与肝癌联合脾脏切除组术后感染、消化道出血、腹水、黄疸的发生率分别为10%和0%、6.67%和4%、20%和16%、20%和20%。两种术式的患者术后肝功能差异无统计学意义,而肝癌联合脾脏切除组能明显改善术后血常规。结论:应严格掌握肝癌联合脾脏切除的手术指征,同时应加强围手术期管理。肝癌联合脾切除术治疗肝癌合并肝硬化脾功能亢进是安全可行的。
Objective: To investigate the clinical efficacy of hepatocellular carcinoma combined with splenectomy and simple hepatectomy in patients with liver cancer complicated with liver cirrhosis and hypersplenism. Methods: Of the 55 patients with liver cancer complicated with cirrhosis and hypersplenism, 25 patients underwent hepatectomy combined with splenectomy and 30 patients underwent simple hepatectomy. The complication, liver function and blood routine were compared and analyzed. Results: The incidences of postoperative infection, gastrointestinal bleeding, ascites and jaundice were 10% and 0%, 6.67% and 4%, 20% and 16%, 20% and 20% %. There was no significant difference in postoperative liver function between the two surgical procedures, while the combination of HCC and splenectomy could obviously improve the postoperative blood routine. Conclusion: The surgical indications for hepatocellular carcinoma combined with splenectomy should be strictly grasped. At the same time, perioperative management should be strengthened. Liver cancer combined with splenectomy in the treatment of liver cancer with liver cirrhosis and hypersplenism is safe and feasible.