摘要
目的观察脾切除术对肝豆状核变性(HLD)合并脾功能亢进(脾亢)患者肝功能的影响。方法回顾性分析178例行脾切除术治疗的HLD合并脾亢患者的临床资料,比较术前与术后第1、14天患者肝功能以及肝动脉、门静脉内径的变化。结果术后第1天的ALT、AST、总胆红素水平高于术前,白蛋白水平低于术前;术后第14天的ALT、AST、总胆红素水平和凝血酶原时间均低于术前及术后第1天,而白蛋白水平均高于术前及术后第1天(均P<0.05)。术后第1天患者的Child-Pugh分级A级占比低于术前,而术后第14天Child-Pugh分级A级占比均高于术前及术后第1天(均P<0.05)。肝动脉内径随着时间延长而逐渐增大;术后第14天的门静脉内径均小于术前及术后第1天(均P<0.05)。结论脾切除术治疗HLD合并脾亢可明显改善患者肝功能,缩短患者凝血酶原时间,其原因可能与脾切除术后患者肝动脉内径增大,而门静脉内径减小有关。
Objective To observe the effect of splenectomy on liver function in patients with hepatolenticular degeneration(HLD)complicated with hypersplenism.Methods The clinical data of 178 patients with HLD complicated with hypersplenism undergoing splenectomy were retrospectively analyzed,and changes in liver function,hepatic artery diameter and portal vein diameter before operation,and one and 14 days after operation were observed in the patients.Results On the first day after operation,the levels of ALT,AST and TBIL were higher while the level of albumin was lower in comparison with the levels before operation(all P<0.05);on the 14th day after operation,the levels of ALT,AST and TBIL were lower and prothrombin time was shorter as compared with those before operation or on the first day after operation,whereas the level of albumin was higher than that before operation or on the first day after operation(all P<0.05).The proportion of patients with Child-Pugh A on the first day after operation was lower than that before operation,whereas the proportion of patients with Child-Pugh A on the 14th day after operation was higher than that before operation or on the first day after operation(all P<0.05).Hepatic artery diameter increased gradually over time,portal vein diameter on day 14 postoperatively was smaller than that before operation or on day 1 post operatively(all P<0.05).Conclusion Splenectomy can significantly improve liver function and reduce prothrombin time in the treatment of patients with HLD complicated with hypersplenism,which may be related to increased hepatic artery diameter and decreased portal vein diameter in the patients after splenectomy.
作者
魏肥生
于庆生
潘晋方
沈毅
张琦
王振
黄龙
WEI Fei-sheng;YU Qing-sheng;PAN Jin-fang;SHEN Yi;ZHANG Qi;WANG Zhen;HUNAG Long(Graduate School,Anhui University of Chinese Medicine,Hefei 230031,China;Department of General Surgery Ward 1,the First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China;Institute of Traditional Chinese External Medicine,Anhui Academy of Chinese Medicine,Hefei 230031,China)
出处
《广西医学》
CAS
2020年第19期2475-2477,2491,共4页
Guangxi Medical Journal
基金
“十二五”国家临床重点专科建设项目(财社〔2013〕239号)。
关键词
肝豆状核变性
脾功能亢进
脾切除术
肝功能
Hepatolenticular degeneration
Hypersplenism
Splenectomy
Liver function
