摘要
目的研究经门静脉输注自体骨髓对失代偿期肝硬化的治疗作用。方法对2021年12月至2023年12月在上海中医药大学附属曙光医院、上海市浦东新区中医医院、上海中医药大学附属龙华医院、上海中医药大学附属岳阳医院治疗的90例失代偿期肝硬化患者进行前瞻性研究。其中45例进行保肝利尿等常规药物治疗(常规治疗组),45例进行常规治疗+自体骨髓经门静脉输注(联合治疗组)。比较两组治疗后6个月的肝功能指标和评分。结果治疗后1、3、6个月,两组患者总胆红素(TBIL)和谷丙转氨酶(ALT)水平均较治疗前下降,差异有统计学意义(P<0.05)。联合治疗组治疗后3、6个月Child-Pugh评分较治疗前下降;治疗后6个月血小板计数(PLT)较治疗前上升、活化部分凝血活酶时间和MELD评分较治疗前下降,差异有统计学意义(均P<0.05);常规治疗组这些指标较治疗前差异无统计学意义(均P>0.05)。治疗后1、3、6个月联合治疗组TBIL水平均较常规治疗组低,治疗后3、6个月联合治疗组Child-Pugh评分均较常规治疗组低,治疗后6个月联合治疗组ALT水平和MELD评分较常规治疗组低,PLT较常规治疗组高,差异均有统计学意义(均P<0.05)。结论常规治疗虽然对部分肝硬化指标有改善,但联合治疗的总体效果更佳,维持时间更持久。自体骨髓移植可以明显促进失代偿期肝硬化患者的肝功能重建,改善肝硬化情况,降低Child-Pugh评分等级,为下一步脾切除手术创造窗口期。
Objective To study the therapeutic effect of autologous bone marrow infusion via portal vein for patients with decompensated cirrhosis.Methods The clinical data of 90 patients with decompensated cirrhosis,who received autologous bone marrow infusion via portal vein between Dec.2021 and Dec.2023,were prospectively analyzed.Among 90 patients,45 cases were treated with routine liver protection and diuresis drugs(the routine treatment group),and 45 cases were treated with routine drugs and autologous bone marrow infusion via portal vein(the combined treatment group).The indexes and scores of liver function were compared between the two groups within 6 months after treatment.Results Compared with the pre-treatment values,the levels of total bilirubin(TBIL)and alanine aminotransferase(ALT)in both groups decreased significantly at 1,3 and 6 months of post-treatment(P<0.05).Compared with pre-treatment,Child-Pugh score showed a decrease trend at 3 and 6 months of post-treatment,platelet count(PLT)showed an increase trend,and activated partial thromboplastin time and MELD score showed decrease trends in combined treatment group at 6 months of posttreatment,with statistically significant difference(all P<0.05);there was no statistically significant difference in these indicators between pre-and post-treatment in the routine treatment group(all P>0.05).The TBIL in the combined treatment group were lower than those in the routine treatment group at 1,3 and 6 months of post-treatment.The Child-Pugh score in the combined treatment group was lower than that in the conventional treatment group at 3 and 6 months of post-treatment.The ALT and MELD scores in the combined treatment group were lower than those in the conventional treatment group at 6 months post-treatment,and the plt was higher than that in the conventional treatment group.The differences were statistically significant(all P<0.05).Conclusion Although routine treatment can improve certain indicators of liver cirrhosis,but combined treatment has more significant overall efficacy and longer maintenance time.Autologous bone marrow transplantation can significantly promote liver function reconstruction in cases of decompensated cirrhosis,which can improve the condition of cirrhosis,lower the Child-Pugh score level,and create a window period for splenectomy surgery.
作者
阎良
应荣
花东明
黄建平
刘岗
顾宏刚
叶圳
冯寿全
梁超
冯煜
YAN Liang;YING Rong;HUA Dongming;HUANG Jianping;LIU Gang;GU Honggang;YE Zhen;FENG Shouquan;LIANG Chao;FENG Yu(Department of General Surgery,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China;Department of General Surgery,Shanghai Pudong New Area Hospital of Traditional Chinese Medicine,Shanghai 201205,China;Department of Hepatobiliary Surgery,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200030,China;Department of Hepatobiliary Surgery,Yueyang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200080,China)
出处
《肝胆胰外科杂志》
CAS
2024年第11期659-663,共5页
Journal of Hepatopancreatobiliary Surgery
关键词
自体骨髓移植
失代偿期肝硬化
肝功能重建
经门静脉输注
autologous bone marrow transplantation
decompensated cirrhosis
liver function reconstruction
portal vein infusion
