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目的：探讨脾动脉结扎联合肝癌切除术对肝癌并门静脉高压症的治疗效果和临床应用的价值。方法：对2008 年10 月至 2013 年10 月期间我院收治的84例肝癌并门静脉高压症患者的资料进行回顾性分析，其中脾动脉结扎联合肝癌切除手术的患者 50 例为研究组，患者34 例行肝癌切除及脾切断流术为对照组。比较两组治疗效果及患者术前、术后情况。结果：研究组术前白细胞计数、血小板计数、红细胞计数为（3.1± 0.9）× 109/L、（58.6± 12.7）× 109/L、（3.4± 0.4）× 109/L，术后2 周白细胞计数、血小板计数、红细胞计数分别为（5.9± 1.5）× 109/L、（140.3± 50.1）× 109/L、（3.6± 0.7）× 109/L；对照组为术前白细胞计数、血小板计数、红细胞计数为（2.8± 1.2）× 109/L、（45.8± 20.5）× 109/L、（3.4± 0.4）× 109/L，术后2 周白细胞计数、血小板计数、红细胞计数为（6.2± 0.7） × 109/L、（172.5± 32.7）× 109/L、（3.6± 0.3）× 109/L。研究组与对照组相比，术后2 周白细胞计数、红细胞计数相比差异无统计学意义（P >0.05），但术后2周血小板计数研究组低于对照组，差异有统计学意义（P <0.05）。研究组术前与术后的白细胞计数、血小板计数、红细胞计数相比，差异均有统计学意义（P <0.05）。研究组有17例患者出现术后并发症，占16.0%；对照组有20例患者出现术后并发症，占38.2%；两组对比差异有统计学意义（P<0.05）。结论：根据病情合理选择使用脾动脉结扎联合肝癌切除术治疗肝癌并门静脉高压症，可以有效治疗肝癌和脾功能亢进，促进肝功能恢复，对延长原发性肝癌合并肝硬化脾功能亢进患者的生存时间，提高生活质量，具有重要意义。

英文摘要:

Objective:To investigate the clinical value of splenic artery ligation combined with hepatic resection for the treatment of hepatocellular carcinoma with portal hypertension.Methods:84 cases of HCC patients with portal hypertension from October 2008 to October 2013 in our hospital were analyzed retrospectively, 50 cases of splenic artery ligation combined with hepatic resection operation were in the study group, 34 patients underwent hepatectomy and splenectomy and devascularization were in the control group. Effects and postoperative situation were compared between groups.Results:The white blood cell count, platelet count, erythrocyte count in study group were (3.1± 0.9) × 109/L, (58.6± 12.7) × 109/L, (3.4± 0.4) × 109/L, 2 weeks after the operation, the white blood cell count, platelet count, erythrocyte counts were (5.9± 1.5) × 109/L,(140.3± 50.1) × 109/L, (3.6± 0.7) × 109/L; In the control group, the white blood cell count, platelet count, erythrocyte count was (2.8 ± 1.2) × 109/L,(45.8± 20.5)× 109/L, (3.4± 0.4)× 109/L and 2 weeks after operation, they were (6.2± 0.7) × 109/L, (172.5± 32.7)× 109/L, (3.6± 0.3)× 109/L respectively. 2 weeks after the operation, there was no significant difference in the white blood cell count, red cell count,（P>0.05）between the 2 groups,but platelet count was lower in the control group,, the difference was statistically significant（P<0.05）. The postoperative white blood cell count, platelet count and erythrocyte count all showed statistically significant, the differences when compared to those before the treatment (P<0.05). In the study group, 17 patients had postoperative complications, accounting for 16%in; the control group, 20 cases were with postoperative complications, accounting for 38.2%; the difference was statistically significant (P<0.05).Conclusion:Splenic artery ligation combined with liver resection for hepatocellular carcinoma and portal hypertension can be effective in the treatment of hepatocellular carcinoma with hypersplenism. It can promote the recovery of liver function, prolong the survival time in patients with primary liver cancer complicated with liver cirrhosis and hypersplenismand improve the quality of life.

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