摘要
目的探讨门脉高压症巨脾大部切除后残脾组织内胶原、弹力及网状纤维的变化，为巨脾保脾术寻找理论依据。方法选取门静脉高压症脾肿大患者13例，采用手术和穿刺活检获取脾组织标本，分为巨脾组和残脾组。另设外伤性脾破裂标本13例为对照组。应用Masson染色、EVG染色及改良氨银染色，光镜下进行比较分析。结果胶原纤维、弹力纤维、网状纤维含量，残脾组分别为（7．81±0．83）％、（7．72±3．42）％、（4．67±1．09）％；巨脾组分别为（7．76±0．81）％、（7．21±3．18）％、（4．79±1．20）％；对照组分别为（3．21±0．51）％、（1．67±3．22）％、（10．92±0．86）％。残脾组胶原、弹力、网状纤维含量与巨脾组比较差异无统计学意义（P〉0．05）。残脾组与巨脾组胶原和弹力纤维含量比对照组增多，差异有统计学意义（P〈0．05）；残脾组和巨脾组网状纤维含量比对照组减少，差异有统计学意义（P〈0．05）。结论巨脾大部切除残脾固定腹膜后，不会加重脾组织的纤维化程度。
Objective To investigate the changes in collagen, elastic and reticular fibers in the splenic remnant after subtotal splenectomy for splenomegaly, and to study for the basis for spleen- preservation technique for this condition. Methods We studied 13 patients with splenomegaly due to portal hypertension. The specimens were obtained by operation and puncturing biopsy, and they were divided into the splenomegaly group and the splenic remnant group. The control group consisted of 13 patients with traumatic splenic rupture. Using Masson staining, EVG staining, and Silver stai- ning, the samples were analyzed using light microscopy after staining. Results The relative contents of collagen fibers （RCC）, elastic fibers （RCE）, and reticular fibers （RCR） in the splenic remnant, the splenomegaly, and the normal spleen were （7.81 ± 0.83） %, （7.72 ±3.42） %, （4. 67± 1.09 ） % （7.76±0.81）%, （7. 21±3.18） %, （4. 79±1.20）%; （3.21±0.51）%, （1.67±3.22）%, （10.92± 0.86） %, respectively. There was no difference between the splenomegaly and the splenic remnant for the three kinds of fiber content （P〈0.05）. Significantly higher numbers of collagen and elastic fibers were observed in the control group when compared with the splenic remnant and the splenomegaly groups （P〈0.05）. Significantly lower numbers＇of reticular fibers were observed in the splenic rem- nant and the splenomegaly groups when compared with the control group （P〈0. 05）. Conclusions As the remnant spleens were fixed in retropertoneum after subtotal splenectomy, there could not be excessive fibrosis in the splenic tissues.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2013年第3期208-211,共4页
Chinese Journal of Hepatobiliary Surgery
关键词
脾
病理学
脾切除术
Spleen
Pathology
Splenectomy
