摘要
目的探讨肝细胞癌合并肝硬化患者肝癌切除时联合脾切除的临床意义。方法将我科收治肝癌合并肝硬化患者分成 2组 ,即切脾组 (11例 )和保脾组 (15例 ) ,比较 2组患者手术前后肝功能与血象改变。结果切脾组术后 14d白细胞和血小板计数分别为 (8 9± 1 6 )× 10 9/L、(310±32 )× 10 9/L ,明显高于保脾组 (3 7± 1 4 )× 10 9/L和 (10 4± 4 1)× 10 9/L(P <0 0 1)。术后第 7天切脾组血清总胆红素为 (2 4± 7) μmol/L ,低于不切脾组 (37± 13) μmol/L ,P <0 0 5。 2组间术后并发症发生率差异无显著意义。结论肝细胞癌合并肝硬化患者肝癌切除时联合脾切除提高白细胞和血小板计数 ,减轻术后肝脏胆红素代谢负担 。
ObjectiveTo study the clinical significance of splenectomy in cirrhotic patients undergoing hepatic resection for PLC.Methods26 PLC patients with portal hypertension and hypersplenism were randomly divided into two groups: incidental splenectomy group ( n =11), and hepatectomy only group ( n =15). Postoperative blood picture and liver function was compared.ResultsThe WBC and PLT count significantly elevated after splenctomy, (8 9±1 6)×10 9 /L, (310±32)×10 9 /L; vs. (3 7±1 4)×10 9 /L and (104±41)×10 9 /L respectively (all P <0 05).The postoperative T Bil concentration was lower in the former (24±7)?μmol/L vs. ( 37± 13)?μmol/L, P <0 05.ConclusionIncidental splenectomy in PLC cirrhotic patients undergoing hepatectomy improved the patients′ blood picture and liver function not at the expense of increased postoperative morbidity.
出处
《中华普通外科杂志》
CSCD
北大核心
2002年第6期328-329,共2页
Chinese Journal of General Surgery
基金
卫生部科研基金资助项目 (94113 6)
