脾切除联合门奇静脉断流术治疗乙型肝炎肝硬化门脉高压症患者疗效研究

目的 探讨采用脾切除(SPL)联合门奇静脉断流术(PAD)治疗乙型肝炎肝硬化门脉高压症患者的临床疗效.方法 2017年2月～2019年11月我院诊治的87例乙型肝炎肝硬化门脉高压症患者,其中45例接受SPL联合PAD治疗(观察组),另42例接受胃底曲张静脉栓塞术和部分脾栓塞术(对照组).测量上臂围和三头肌皮褶厚度,使用...

Re-observation of splenectomy and esophagogastric devascularization in patients with hepatitis B cirrhosis and portal hypertension

Objective The aim of this study was to re-observe the clinical efficacy of splenectomy (SPL) and portal-azygous disconnection (PAD) in treating patients with hepatitis B cirrhosis and portal hypertension. Methods A total of 87 patients with hepatitis B cirrhosis and portal hypertension were enrolled in our hospital between Februar y 2017 and November 2019, and 45 patients out of them received SPL and esophagogastric devascularization (observation group) and 42 patients underwent percutaneous transhepatic variceal embolization ( PTVE) and partial splenic embolization. The body mass index (BMI), mid-upper arm circumference (MUAC) and riceps skinfold thickness (RST) were measured. The portal venous flow (PVF), superior mesenteric venous flow (SMVF) and splenic venous flow ( SVF) were measured by sonography. Results One month after operation, the BMI, MUAC and RST in the observation were (21.5±1.3)kg/m², (22.1±1.0)cm and (10.3±1.0)mm, not significantly different as compared to in the control; the PVF and SMVF were (670.9±46.2)ml/min and (583.5±69.0)ml/min, significantly different compared to in the control; serum albumin levels was (34.0±1.4)g/L, significantly higher than in the control; the incidence of post-operational complications was 8.9%, much lower than 38.1%(P<0.05) in the control. Conclusion The classic splenectomy and esophagogastric devascularization combination is still an important choice of treatment for patients with hepatitis B cirrhosis and portal hypertension, which might reduce the portal pressure, improve liver function and liver blood perfusion with fewer complications.