肝癌切除联合全脾切除治疗原发性肝癌合并脾功能亢进的疗效分析

目的：探讨临床治疗原发性肝癌合并脾功能亢进的有效方案。方法：回顾分析163例原发性肝癌合并脾功能亢进患者的临床资料，根据治疗方案将上述患者分为观察组（n=83）与对照组（n=80），观察组接受肝癌切除术联合全脾切除术治疗，对照组仅接受肝癌切除术治疗。结果：（1）两组患者术中出血量、输血量比较差异无统计学意义（P〉0．05）。（2）术前，两组患者红细胞（RBC）、白细胞（WBC）、血小板（PLT）比较差异无统计学意义（P〉0．05）；术后2个月，观察组WBC、PLT显著高于对照组（P〈0．05），两组患者RBC比较差异无统计学意义（P〉0．05）。（3）术前，两组患者CD4、CD8、CD4／CD8比较差异无统计学意义（P〉0．05）；术后2个月，观察组C现、CD4／CD8显著高于对照组（P〈0．05），CD。显著低于对照组（P〈O．05）。（4）两组患者并发症发生率、病死率比较差异无统计学意义（P〉0．05）。结论：肝癌切除术联合全脾切除术是治疗原发性肝癌合并脾功能亢进的有效方案，该方案值得临床应用与推广。

Efficacy of Liver Cancer Resection Combined with Splenectomy in the Treatment of Primary Hepatocellular Carcinoma with Hypersplenism

Objective： To investigate the effective regimen for primary hepatocellular carcinoma with hypersplenism.Method： The clinical data of 163 cases of primary hepatocellular carcinoma with hypersplenism were analyzed retrospectively.According to the surgical regimen, these patients were divided into an observation group （ n=83 ） and a control group （ n=80 ）, and the observation group received liver cancer resection combined with splanectomy, while the control group received liver cancer resection only.Result： （ 1 ） No significant differences were found in perioperative blood loss and blood transfusion volume between the 2 groups （ P〉0.05 ） . （ 2 ） Before surgery, no significant differences were found in red blood cell （ RBC ）, white blood cell （ WBC ） and platelet （ PLT ） between the 2 groups （ P〉0.05 ） . 2 months after surgery, the WBC and PLT in the observation group were statistically higher than those in the control group respectively（ P〈0.05 ）,while no significant difference in RBC was found between the 2 groups（ P〉0.05 ）.（ 3 ） Before surgery, no significant differences were found in CD4, CD8 and CD4/CD8 between the 2 groups （P〉0.05） . 2 months after surgery, the CD4 andCD4/CD8 in the observation group were statistically higher than those in the control group respectively （ P〈0.05 ）, while the CD8 was lower than that in the control group （ P〈0.05 ） . （ 4 ） No significant differences were found in complication rate and mortality rate between the 2 groups （ P〉0.05 ） .Conclusion： The liver cancer resection combined with splenectomy is an effective regimerl for primary hepatocellular carcinoma with hypersplenism, and this surgical regimen is worthy of being applied and popularized.