Splenic artery aneurysm is one of the most common visceral aneurysms,and patients with this type of aneurysm often present without symptoms.However,when rupture occurs,it can be a catastrophic event.Although most of t...Splenic artery aneurysm is one of the most common visceral aneurysms,and patients with this type of aneurysm often present without symptoms.However,when rupture occurs,it can be a catastrophic event.Although most of these aneurysms can be treated with percutaneous embolization,some located in uncommon parts of the splenic artery may make this approach impossible.We present a patient with an aneurysm in the proximal splenic artery,close to the celiac trunk,which was treated by laparoscopic ligation only,without resection of the aneurysm,and with long-term preservation of splenic function.展开更多
Objective:To discover the effect of partial splenic embolization on the immune function of cirrhotic patients with hypersplenism.Methods:Patients involved in the study were enrolled and divided into three groups,inclu...Objective:To discover the effect of partial splenic embolization on the immune function of cirrhotic patients with hypersplenism.Methods:Patients involved in the study were enrolled and divided into three groups,including control group,experimental group,and complication group.Numbers of CD3^+,CD4^+ and CD8^+ T cells and CD4^+CD25^+CDl27^(low/-) Treg cells in the peripheral blood of patients before surgery,1 month,6 months,1 year,and 2 years after surgery were analyzed by fluorescence active cell sorting(FACS).Contents of immunoglobulins(IgA,IgG and IgM) were analyzed by auto immunoassay analyzer.Results:In the peripheral blood of patients from experimental group,numbers of CD3^+,CD4^+ and CD8^+ T cells initially declined,but afterwards increased to normal level;in the peripheral blood of patients from complication group,CD3^+ and CD8^+ T cells showed the same trend,but the number of CD4^+ T cells was below normal level at all detection times.Furthermore,CD3^+,CD4^+ and CD8^+ T cells in the peripheral blood of patients from complication group were initially less than those in experimental group,and afterwards were comparable between two groups.In patients from both experimental group and complication group,the number of CD4^+CD25^+CDl27^(low/-)Treg cells increased 1 month and 6 months after surgery,and gradually restored to normal level.CD4^+CD25^+CDl27^(low/-)Treg cell counts in patients from complication group were initially more than those in patients from experimental group 1 month and 6 months after surgery,but then they were comparable.Furthermore,contents of immunoglobulins(IgA,IgG and IgM) were comparable in three groups at all detection times.Conclusion:Partial splenic embolization influenced the immune function of cirrhotic patients with hypersplenism in the short term but the immune function could afterwards gradually restore to normal.Our results implicated that measures that prevent infection and improve immune function were necessary in early stage after undergoing PSE in order to reduce complications.展开更多
目的:比较腹腔镜脾切除术和开腹脾切除术治疗创伤性脾破裂(TSR)的效果及安全性。方法:选择2022年1月—2024年6月于新余市人民医院手术治疗的80例TSR患者作为研究对象,随机分为观察组和对照组,各40例。对照组行开腹脾切除术治疗,观察组...目的:比较腹腔镜脾切除术和开腹脾切除术治疗创伤性脾破裂(TSR)的效果及安全性。方法:选择2022年1月—2024年6月于新余市人民医院手术治疗的80例TSR患者作为研究对象,随机分为观察组和对照组,各40例。对照组行开腹脾切除术治疗,观察组采用腹腔镜脾切除术治疗。比较两组术中指标、术后恢复情况、并发症发生率、VAS评分、PLT和免疫功能变化情况。结果:相较于对照组,观察组脾动脉阻断时间、术后排气时间、术中出血量、胃管拔除时间、腹腔引流时间、住院时间及术后并发症发生率均更优,而观察组手术时间较对照组更长(P<0.05);观察组术后1、2、3 d VAS评分均低于对照组(P<0.05);术后3 d,两组CD4^(+)、CD4^(+)/CD8^(+)水平均较术前降低,且相较于对照组,观察组CD4^(+)、CD4^(+)/CD8^(+)水平均更高(P<0.05);术后3 d,两组PLT、CD8^(+)水平均较术前升高,且相较于对照组,观察组PLT、CD8^(+)水平均更低(P<0.05)。结论:相较于开腹脾切除术,腹腔镜脾切除术治疗TSR患者的效果更好,可有效缩短术后康复时间,缓解患者不适,保护免疫功能及改善预后。展开更多
基金Supported by Key Disciplines of Medicine,Zhejiang Province,China,No.11-CX21
文摘Splenic artery aneurysm is one of the most common visceral aneurysms,and patients with this type of aneurysm often present without symptoms.However,when rupture occurs,it can be a catastrophic event.Although most of these aneurysms can be treated with percutaneous embolization,some located in uncommon parts of the splenic artery may make this approach impossible.We present a patient with an aneurysm in the proximal splenic artery,close to the celiac trunk,which was treated by laparoscopic ligation only,without resection of the aneurysm,and with long-term preservation of splenic function.
文摘Objective:To discover the effect of partial splenic embolization on the immune function of cirrhotic patients with hypersplenism.Methods:Patients involved in the study were enrolled and divided into three groups,including control group,experimental group,and complication group.Numbers of CD3^+,CD4^+ and CD8^+ T cells and CD4^+CD25^+CDl27^(low/-) Treg cells in the peripheral blood of patients before surgery,1 month,6 months,1 year,and 2 years after surgery were analyzed by fluorescence active cell sorting(FACS).Contents of immunoglobulins(IgA,IgG and IgM) were analyzed by auto immunoassay analyzer.Results:In the peripheral blood of patients from experimental group,numbers of CD3^+,CD4^+ and CD8^+ T cells initially declined,but afterwards increased to normal level;in the peripheral blood of patients from complication group,CD3^+ and CD8^+ T cells showed the same trend,but the number of CD4^+ T cells was below normal level at all detection times.Furthermore,CD3^+,CD4^+ and CD8^+ T cells in the peripheral blood of patients from complication group were initially less than those in experimental group,and afterwards were comparable between two groups.In patients from both experimental group and complication group,the number of CD4^+CD25^+CDl27^(low/-)Treg cells increased 1 month and 6 months after surgery,and gradually restored to normal level.CD4^+CD25^+CDl27^(low/-)Treg cell counts in patients from complication group were initially more than those in patients from experimental group 1 month and 6 months after surgery,but then they were comparable.Furthermore,contents of immunoglobulins(IgA,IgG and IgM) were comparable in three groups at all detection times.Conclusion:Partial splenic embolization influenced the immune function of cirrhotic patients with hypersplenism in the short term but the immune function could afterwards gradually restore to normal.Our results implicated that measures that prevent infection and improve immune function were necessary in early stage after undergoing PSE in order to reduce complications.
文摘目的:比较腹腔镜脾切除术和开腹脾切除术治疗创伤性脾破裂(TSR)的效果及安全性。方法:选择2022年1月—2024年6月于新余市人民医院手术治疗的80例TSR患者作为研究对象,随机分为观察组和对照组,各40例。对照组行开腹脾切除术治疗,观察组采用腹腔镜脾切除术治疗。比较两组术中指标、术后恢复情况、并发症发生率、VAS评分、PLT和免疫功能变化情况。结果:相较于对照组,观察组脾动脉阻断时间、术后排气时间、术中出血量、胃管拔除时间、腹腔引流时间、住院时间及术后并发症发生率均更优,而观察组手术时间较对照组更长(P<0.05);观察组术后1、2、3 d VAS评分均低于对照组(P<0.05);术后3 d,两组CD4^(+)、CD4^(+)/CD8^(+)水平均较术前降低,且相较于对照组,观察组CD4^(+)、CD4^(+)/CD8^(+)水平均更高(P<0.05);术后3 d,两组PLT、CD8^(+)水平均较术前升高,且相较于对照组,观察组PLT、CD8^(+)水平均更低(P<0.05)。结论:相较于开腹脾切除术,腹腔镜脾切除术治疗TSR患者的效果更好,可有效缩短术后康复时间,缓解患者不适,保护免疫功能及改善预后。
