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目的：探讨脾切除术对肝炎后肝硬化脾亢患者的肝癌发生发展的影响。方法：回顾性研究369 名肝硬化脾亢伴或不伴肝癌患者，经倾向性得分匹配方法(PS法)均衡分为无脾切除组（246 例）和脾切除组（123 例），分别比较脾切组中脾切除术对患者肝功能的影响和两组间肝癌发生率的差异。结果：脾切除术后患者AST、ALT在短期内有轻微升高，WBC和PLT记数明显增加，血清 TBIL和PT也都降低。无脾切除组和脾切除组的肝癌发生率分别为33.33%和12.26%，卡方检验结果P<0.05，有统计学意义。结论：脾切除术不但可以改善肝硬化肝癌患者的肝功能，还可以降低肝硬化脾亢患者肝癌发生的危险。

英文摘要:

Objective: To explore the impact of splenectomy to hepatocacinogensis in hepatitis cirrhosis patients with hypersplenism. Methods: 369 patients with hypersplenism secondry to liver cirrhosis with or without hepatocellular carcinoma (HCC) were divided into 2 cohorts, non-splenectomy cohort with 246 patients and splenectomy cohort with 123 patients. To compared the effects of liver function before and after operation in splenectomy cohort, and study the different incidence of HCC between the two cohorts, respectively. Results: Compared to non-splenectomy cohort, AST and AST were significantly decreased in splenectomy cohort. And the levels of serum total bilirubin and PT were decreased too. While the WBC and PLT counts were significantly increased. The incidences of HCC were 33.33% in non-splenectomy cohort and 12.26% in splenectomy cohort, respectively. So there was a significant difference between pre- and pro-operation in morbidity of HCC (P<0.05). Conclusion: Splenetomy not only can improve the liver function of hepatic cirrhosis patients, but also can reduce the risk of hepatocacinogensis in hepatitis cirrhosis patients with hypersplenism.

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