摘要
目的观察终末期肝病伴门静脉高压脾功能亢进患者肝移植术中行脾动脉结扎对肝功能恢复和脾功能亢进的影响.方法回顾性收集2016年1月至2019年1月宁波市李惠利医院行肝移植手术患者的临床资料,其中术前合并终末期肝病及门静脉高压脾功能亢进患者53例.依据术中是否接受脾动脉结扎,分为结扎组(n=23)及未结扎组(n=30),观察患者术后短期内肝功能及白细胞、血小板等指标的变化,同时比较两组患者术后并发症的发生情况.结果经倾向得分匹配(PSM)法均衡组间协变量后,共有20对匹配成功,Ⅰ组(结扎组)和Ⅱ组(未结扎组)所有患者随访时间均超过6个月.术后2周内,两组各时点肝功能指标比较差异无统计学意义;术后6个月内,两组各时点血小板计数、白细胞计数、红细胞计数比较差异无统计学意义;两组术后感染、消化道出血、脾动脉窃血综合征等并发症的发生率比较,差异无统计学意义.结论肝移植术中行脾动脉结扎未影响围手术期肝功能的恢复,术后短期内对于脾功能亢进的缓解也无显著影响.
Objective To evaluate the efficacy of splenic artery ligation on liver function recovery and hypersplenism in liver transplant patients with end-stage liver disease complicating portal hypertension and hypersplenism.Methods FVom Jan 2016 to Jan 2019,the clinical data of patients undergoing liver transplantation ai our hospital were analyzed retrospectively,among which 53 patients were enrolled in the study with end-stage liver disease complicated with portal hypertension and hypersplenism.Patients were divided into ligation group(n=23)and no ligation group(n=30).The serum liver function and white blood cells,platelets and postoperative complications were compared.Results 20 pairs of patients were successfully matched by PSM method.All patients were followed up for over 6 months.There was no statistically significant difference between the two groups in all the observation points within 2 weeks after operation;Within 6 months,there was no statistically significant difference in WBC,platelet and 11gb.Statistically significant differences in postoperative complications such as infection,gastrointestinal bleeding,and splenic artery stealing syndrome were also not found between these two groups.Conclusions Splenic artery ligation during liver transplantation does not accelerate liver function recovery nor ameliorate hypersplenism.
作者
熊超杰
虞哲伟
胡杨科
陆才德
黄静
Xiong Chaojie;Yu Zhewei;Hu Yangke;Lu Caidei;Huang Jing(School of Medicine,Ningbo University,Ningbo 315211,China;Department of Hepatobiliary Pancreatic Surgery,Ningbo Medical Center Lihuili Hospital,Ningbo 315040,China)
出处
《中华普通外科杂志》
CSCD
北大核心
2020年第7期516-520,共5页
Chinese Journal of General Surgery
基金
宁波市科技创新团队(2013B82010)
宁波市医疗卫生品牌学科建设项目(PPXK2018-03)
浙江省医药卫生科技项目(2019ZD074)。
关键词
肝移植
高血压
门静脉
脾功能亢进
Liver transplantation
Hypertension
portal
Hypersplenism
