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作者	单位	E-mail
陆世锋	广西中医药大学第一附属医院肝胆外科广西南宁 530023	meidyz@163.com
潘　孟	广西中医药大学第一附属医院肝胆外科广西南宁 530023
左江伟	广西省南宁市二医院肝胆外科广西南宁 530000
廖　轲	广西中医药大学第一附属医院肝胆外科广西南宁 530023
许　斌	广西中医药大学第一附属医院肝胆外科广西南宁 530023

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中文摘要:

摘要目的：研究脾切除术与部分脾动脉栓塞术对脾功能亢进患者的影响。方法：选取我院外科确诊为乙型病毒性肝炎后肝硬化伴脾功能亢进症患者38例，通过随机数表法将所有患者平分为观察组和对照组，观察组给予部分脾动脉栓塞术，对照组给予脾切除术。检测术前术后血细胞计数、细胞免疫指标和体液免疫指标。结果：术后7天，对照组的红细胞略低于实验组（χ²=0.118，P=0.906）；对照组的白细胞高于实验组（χ²=6.095，P<0.001）；对照组的血小板显著低于实验组（χ²=17.263，P<0.001）；术后28天，对照组的红细胞显著低于实验组（χ²=7.981，P<0.001）；对照组的白细胞明显高于实验组，差异有统计学意义（χ²=4.862，P<0.001）；对照组的血小板低于实验组（χ²=2.165，P=0.037）；术后7天，对照组的CD3略低于实验组（t=0.606，P=0.548），对照组的CD4明显低于实验组，CD8显著高于实验组，CD4/CD8低于实验组，差异均有统计学意义（P<0.001）；术后28天，对照组的CD3略低于实验组（t=0.948，P=0.349）；对照组的CD4略低于实验组（t=2.742，P=0.009）；对照组的CD8显著高于实验组，CD4/CD8低于实验组，差异均无统计学意义（P>0.05）；术后7天，对照组的IgM高于实验组，对照组的IgG略高于实验组，IgA低于对照组，但差异无统计学意义（P>0.05）；术后28天，对照组的IgM高于实验组，对照组的IgG略高于实验组，但差异无统计学意义（P>0.05）；对照组的IgA为（2.76±1.37）g/L，明显低于实验组的（3.79±1.69）g/L（t=2.063，P=0.046）。结论：部分脾动脉栓塞术能有效改善脾亢症状，调节脾脏功能，提升全身性免疫功能，值得在临床中推广。

英文摘要:

ABSTRACT Objective: To study the effects of splenectomy and partial splenic artery embolization on patients with hypersplenism. Methods: In this study included were 38 cases of patients diagnosed with liver cirrhosis after viral hepatitis B and hypersplenism in our hospital. By the method of random number table, they were divided into the observation group and the control group. The observation group was given partial splenic artery embolization, and the control group was treated with splenectomy. Blood cell count, cellular immunity and humoral immunity were detected before and after operation. Results: On the 7th day after operation, the red blood cell level in the control group was slightly lower than in the experimental group (χ²=0.118, P=0.906); The white blood cell level in the control group were higher than in the experimental group (χ²=6.095, P<0.001); and the platelet in the control group was significantly lower than in the experimental group (χ²=17.263, P<0.001). After 28 days, the red blood cell level in control group was significantly lower than in the experimental group (χ²=7.981, P<0.001); while white blood cell levels in the control group was significantly higher than that in the experimental group, and difference had statistical significance (χ²=4.862, P<0.001). The platelet in control group remained lower than in the experimental group (χ²=2.165, P=0.037). At 7 days after surgery, the CD3 level in the control group was slightly lower than in the experimental group (t=0.606, P=0.548), and the CD4 level was significantly lower than in the experimental group, but CD8 level was significantly higher than in the experimental group. The CD4/CD8 was lower in the control group than in the experimental group. All the differences were statistically significant (P<0.001). The IgM was higher, and the IgG slightly higher, but IgA lower in control group than in the experimental group, but the differences were not statistically significant (P>0.05). After 28 days, the CD3 and CD4 were slightly lower in the control group than in the experimental group (t=0.948, P=0.349; t=2.742, P=0.009), while the CD8 was significantly higher in the control group than in the experimental group, and CD4/CD8 was lower than that of the experimental group. All the differences were not statistically significant (P>0.05). The IgM was higher and IgG was slightly higher in the control group than in the experimental group, but the differences were not statistically significant (P>0.05). The IgA was (2.76±1.37)g/L in the control group, but (3.79±1.69)g/L in the experimental group. The IgA was significantly lower in the control group than in the experimental group (t=2.063, P=0.046). Conclusion: Partial splenic embolization can effectively improve the symptoms of hypersplenism, regulate spleen function, and enhance the body immunity, so it is worthy of clinical promotion.

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