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- Title
腹腔镜脾脏切除贲门周围血管离断术治疗 Child-PughA/B 级 肝硬化门静脉高压症的临床效果分析.
- Authors
李昌旭; 徐露瑶; 汝娜; 任雪康; 唐朝辉; 王英超
- Abstract
Objective To investigate the clinical effect of laparoscopic splenectomy and peripheral cardia dissection (LSPD) in patients with portal hypertension, and to further clarify the long-term effect of LSPD. The method was selected from August 2017 to December 2017 in the First Hospital of Jilin University 40 patients with liver function Child-Pugh A/B portal hypertension treated with LSPD (surgical group); 44 patients with liver function Child-Pugh A/B portal hypertension who received conservative treatment during the same period were selected (internal medicine group). As of June 30, 2019, record the liver function indicators, upper gastrointestinal bleeding and portal vein thrombosis of the two groups of patients at each time point. The measurement data of the normal distribution between the two groups was compared by t test; the comparison between multiple groups was compared by analysis of variance The Bonferroni test was used for further pairwise comparisons. The Kruskal-Wallis H test was used for the comparison of skewed distribution measurement data among multiple groups, and the Mann-Whitney U test was used for further pairwise comparisons. The χ2 test was used for the comparison of count data between groups. At 6, 12, and 24 months, the level of cholinesterase in the surgical group was significantly higher than that in the internal medicine group (t values were 3.527, 3.849, and 5.555, respectively, with P values <0.05), and the Child-Pugh score was significantly lower than that in the internal medicine group (t value They were 2.498, 2.138, 2.081, and P values were all <0.05). The albumin level of the surgical group was higher than that of the internal medicine group at 12 and 24 months after discharge (t values were 3.120 and 2.587, respectively), and the upper gastrointestinal bleeding rate was lower than that of the internal medicine group. (χ2 values were 4.947 and 5.155, respectively), and the differences were statistically significant (P values were all <0.05). The number of patients in the surgical group with a significant increase in alpha-fetoprotein level 24 months after discharge was less than that in the medical group, and the difference was statistically significant (χ2 =4.648, P=0.031). The incidence of portal vein thrombosis in the surgical group at 12 months after discharge was significantly higher than that in the internal medicine group (χ2=4.395, P=0.036). Patients in the surgical group were admitted to the hospital, 12 months after surgery, and 24 months after surgery. Albumin (F=2.959, P=0.013), cholinesterase (F=11.022, P<0.001), prothrombin time (H=94.100, P<0.001), Child-Pugh score (F=3.742, P =0.003) were improved. Conclusion Liver function Child-Pugh A/B portal hypertension patients with LSPD can improve liver function and reduce the rate of upper gastrointestinal bleeding. The incidence of portal vein thrombosis is high, but it can be effectively reduced by oral aspirin and rivaroxaban.
- Publication
Journal of Clinical Hepatology / Linchuang Gandanbing Zazhi, 2021, Vol 37, Issue 3, p596
- ISSN
1001-5256
- Publication type
Article
- DOI
10.3969/j.issn.1001-5256.2021.03.018