超声引导经皮门静脉穿刺干细胞移植治疗肝硬化顽固性腹水的疗效观察

目的观察超声引导经皮门静脉穿刺自体骨髓干细胞移植对肝硬化顽固性腹水的临床疗效。方法治疗组(A)64例肝硬化顽固性腹水者在常规治疗基础上行超声引导经皮门静脉穿刺将自体骨髓干细胞植入肝脏。对照组(B1)为本院感染科87例肝硬化并腹水患者,治疗方法为常规治疗基础上经导管将干细胞植入肝脏动脉多级分支血管;对照组(B2)为本院感染科56例肝硬化并腹水患者,行常规治疗。观察治疗组移植后的临床症状、术后不良反应、腹水持续时间、肝肾功能检测,与对照组资料进行对比并作统计学分析。结果骨髓干细胞移植后3个月,治疗组(A)及对照组(B1)患者腹水均有一定程度缓解,腹水增长速度缓慢;肝肾功能明显改善,实验室指标均好转,二者对比差异无统计学意义(P0.05)。与对照组(B2)比较,腹水增长速度、肝肾功能、实验室指标改善改善情况均优于对照组(B2),差异有统计学意义(P0.05)。术后不良反应及并发症治疗组(A)少于对照组(B1),差异有统计学意义(P0.05)。结论自体骨髓干细胞移植治疗肝硬化是目前治疗肝硬化顽固性腹水的一种有效手段,采用超声引导经皮门静脉穿刺干细胞移植治疗肝硬化与肝动脉多级分支自体骨髓干细胞移植疗效一致;经皮门静脉穿刺干细胞移植治疗肝硬化腹水安全有效且不良反应小,可作为中晚期肝硬化患者的临床治疗方案。

Clinical observation of hepatic stem cell transplantation on liver cirrhosis with refractory ascites by ultrasonic guided percutaneous portal vein puncture

Objective To observe the clinical curative effect of autologous stem cells transplantation for decompensated on liver cirrhosis with refractory ascites by ultrasonic guided percutaneous portal vein puncture. Methods For treatment group A （64 cases） of liver cirrhosis with refractory ascites, autologous stem cell was transplanted in liver by ultrasonic guided percutaneous portal vein puncture in the conventional therapy. We gathered materials of 87 cases with liver cirrhosis with refractory ascites of infectious disease department of our hospital and transplanted autologous stem cell into hepatic artery multilevel branch by pipe in the conventional therapy as control group（ B1 ） ;Control group（B2） was given conventional therapy. Observe the clinical symptoms after transplantation, postoperative adverse reaction, time of ascites continued tonormal, liver and kidney function, compared with the control materials and made statistical analysis. Results The ascites had a certain degree of relief after stem cells transplantation, the increment speed of ascites slowed after treatment;both treatment group （A）and control group （B1） patients＇liver and kidney function got better obviously, laboratory indicators were better, there was no significant difference between contrast（P 〉0. 05）. But treatment group （A） was better than that of control group （B2） （P 〈 0. 05）. Postoperative adverse reaction and complication of treatment group （A） were less than those in the control group B1, the differences were significant （P 〈 0.05 ）. Conclusions Autologous stem cell transplantation is an effective means to treat liver cirrhosis currently, both stem cells transplantation by ultrasonic guided percutaneous portal vein puncture and stem cells implanted into hepatic artery multilevel branch by pipe are consistent curative effect. It is safe and less side effect that autologous stem cells transplantation treats liver cirrhosis with refractoryascites by ultrasonic guided percutaneous portal vein puncture, and can be used as the clinical treatment of patients with middle-late liver cirrhosis.