TIPS与PSE术治疗乙型肝炎肝硬化并发脾功能亢进症患者疗效研究*

doi:10.3969/j.issn.1672-5069.2023.02.029

摘要/Abstract

摘要： 目的研究经颈静脉肝内门体静脉分流术(TIPS)联合部分脾动脉栓塞术(PSE)治疗乙型肝炎肝硬化并发脾功能亢进症患者的疗效。方法 2018年1月～2021年1月我院诊治的乙型肝炎肝硬化并发脾功能亢进症患者72例,随机分为PSE 治疗组36例和联合组36例,分别行PSE治疗或PSE联合TIPS术治疗,随访1年。结果在治疗后1 w,联合组外周血PLT和WBC计数分别为(76.1±25.8)×10⁹/L和(4.2±1.2)×10⁹/L,显著高于PSE治疗组【分别为(45.8±13.7)×10⁹/L和(2.4±0.5)×10⁹/L,P＜0.05】;在治疗后12 m,联合组外周血PLT和WBC计数分别为(59.3±18.7)×10⁹/L和(2.8±0.9)×10⁹/L,显著高于PSE治疗组【分别为(45.6±14.2)×10⁹/L和(2.0±0.6)×10⁹/L,P＜0.05】;联合组血清白蛋白水平为(37.9±3.4)g/L,显著高于PSE治疗组【(35.9±3.5)g/L,P＜0.05】。术后,联合组支架狭窄和肝性脑病发生率分别为22.2%和33.3%。结论采用TIPS联合PSE术治疗乙型肝炎肝硬化并发脾功能亢进症患者有利于提示血细胞数,可能对防止感染有帮助。

关键词: 肝硬化, 脾功能亢进症, 经颈静脉肝内门体静脉分流术, 部分脾动脉栓塞术, 治疗

Abstract: Objective The purpose of this study was to observe the efficacy of transjugular intrahepatic portal shunt (TIPS) and partial splenic artery embolization (PSE) in the treatment of patients with hepatitis B cirrhosis complicated by hypersplenism. Methods A total of 72 patients with hepatitis B cirrhosis complicated by hypersplenism were encountered in our hospital between January 2018 and January 2021, and were randomly divided into control (n = 36) and combination group (n = 36), receiving PSE or PSE and TIPS combination treatment. All patients were followed-up for one year. Results One week after treatment, the platelet (PLT) and white blood cell (WBC) counts in the combination group were (76.1±25.8) ×10⁹/L and (4.2±1.2) ×10⁹/L, both significantly higher than [(45.8±13.7) ×10⁹/L and (2.4±0.5) ×10⁹/L, respectively, P < 0.05] in PSE-treated patients; at the end of 12 months after operation, the PLT and WBC counts in the combination group were (59.3±18.7) ×10⁹/L and (2.8±0.9) ×10⁹/L, both significantly higher than [(45.6±14.2) ×10⁹/L and (2.0±0.6) ×10⁹/L, respectively, P<0.05] in the PSE-treated patients; serum albumin level in the combination group were (37.9±3.4) g/L, significantly higher than [(35.9±3.5) g/L, P < 0.05] in PSE-treated patients; the incidences of stent stenosis and hepatic encephalophathy after TIPS and PSE were 22.2% and 33.3%. Conclusion The TIPS and PSE is beneficial to alleviate short-term postoperative hypersplenism in patients with hepatitis B liver cirrhosis, which might help improve the compromised functions of immune system.

Key words: Liver cirrhosis, Hypersplenism, Transjugular intrahepatic portal shunt, Partial splenic artery embolization, Therapy

周秋娟, 朱逸明, 马宇航, 陈婷闪. TIPS与PSE术治疗乙型肝炎肝硬化并发脾功能亢进症患者疗效研究^*[J]. 实用肝脏病杂志, 2023, 26(2): 266-269.

Zhou Qiujuan, Zhu Yiming, Ma Yuhang, et al.. Improvement of hypersplenism in patients hepatitis B cirrhosis after TIPS and PSE combination treatment[J]. Journal of Practical Hepatology, 2023, 26(2): 266-269.

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TIPS与PSE术治疗乙型肝炎肝硬化并发脾功能亢进症患者疗效研究^*

Improvement of hypersplenism in patients hepatitis B cirrhosis after TIPS and PSE combination treatment

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