自体脾移植联合食管下段横断术治疗肝硬化门静脉高压症的临床随机对照观察

目的　采用随机对照研究的方法观察用自体脾移植联合食管下段横断术治疗肝硬化门脉高压症的临床效果。方法　将肝功能ChildA、B级的肝硬化门脉高压症患者随机分为自体脾移植组和切脾组 ,脾移植组采用自体带蒂脾组织腹膜后移植联合改良的食管下段横断术 ,切脾组则采用脾切除联合改良的食管下段横断术 ;以患者术前的情况为对照 ,在术后 2～ 8个月观察患者的一般情况、脾扫描、肝功能、血清Tuftsin、IgM水平。结果　术后第六天切脾组死亡 1例 ,脾移植组出现再出血 1例 ;两组血清Tuftsin、IgM水平有显著性差异 (P <0 .0 5 ) ,在对肝功能的影响上无明显差异。结论　脾自体移植后能够长期存活 ,并能够维持脾脏的基本免疫功能 ,是可以在临床上推广应用的。

Clinically randomized comparative obs ervation of spleen autotransplantation combined with lower esopha gus transection in the treatment of hepatic cirrhosis-induced portal hypertension

Objective To observe the therapeutic effect of spleen autotransplantation combined with lower esophagus transection in the treatment of hepatic cirrhosis induced portal hypertension by using randomized comparative method.Methods The hepatic cirrhosis induced portal hypertension patients with Child A or B grade of liver function were randomly divided into spleen autotransplantation group and splenectomy group.In the spleen autotransplantation group, retroperitoneal transplantation of pedicled auto splenic tissue combined with modified lower esophagus transection was performed, while in the splenectomy group, splenectomy combined with modified lower esophagus transection was conducted.The general condition, spleen scanning, liver function, serum Tuftsin and IgM levels in the patients 2 to 8 months after operation were observed and compared with those before operation.Results One case died in the splenectomy group on the 6th postoperative day.Re bleeding occurred in one cases of splenectomy group.There was significant difference in serum Tuftsin and IgM levels between the two groups ( P < 0.05 ).Conclusion Spleen auto grafts could be alive for a long time and maintain the basic immune function of spleen.