门脉断流术联合脾脏切除术与双介入栓塞术治疗肝硬化门脉高压症疗效对比

目的对门脉断流术联合脾脏切除术与双介入栓塞术治疗肝硬化门脉高压症的疗效进行对比。方法分析122例肝硬化门脉高压症的住院患者，其中64例行门脉断流术联合脾脏切除术（手术组），58例行双介入栓塞术（介入组），观察两组患者治疗后1、12月与治疗前血细胞及肝功能变化；两种治疗术后不良反应发生率；术后随访观察1年期间患者死亡率与再出血率。结果两组患者治疗后肝功能均得以改善，白细胞血小板计数较术前明显升高（P〈0．05），红细胞计数无明显变化；介入组患者不良反应发生率高于手术组；术后随访观察1年期间两组患者死亡率差异无统计学意义，但是介入组再出血率高于手术组（P〈0．05）。结论门脉断流术联合脾脏切除术治疗肝硬化门脉高压症安全有效，不良反应发生率低，而且远期疗效优于双介入栓塞术。

Curative effect of portal-vein disconnection combined with splenectomy and double interventional embolization in the treatment of liver cirrhosis portal hypertension

Objective To explore the curative effect of portal-vein disconnection combined with splenectomy and double interventional embolization in the treatment of liver cirrhosis portal hypertension. Methods Retrospective analysis of 122 liver cirrhosis portal hypertension patients in hospital was made： 68 patients in the operation group and 58 patients in the intervention group. The change of blood cell number and liver function were observed after the treatment of 1 month and 12 months; and the complications, the death and the incidence of re-bleeding were observed in the two groups after the treatment of I year. Results The liver function was improved. The number of white cell and platelet were advanced （P 〈0.05）, and the number of red cell had no change after the treatment in the two groups. The incidence of the complications in the intervention group were more serious than that in the operation group. There were no differences in the mortality for both groups. The rate of re-bleeding in the intervention group was higher than that of the operation group （P 〈0.05） during the period of I year. Conclusion The portal-vein disconnection combined with splenectomy is safe, reasonable and effective in the treatment of liver cirrhosis portal hypertension, and the long-term efficacy is superior to double interventional embolization.