中国组织工程研究2012，Vol.16Issue(5)：771-774,4.DOI:10.3969/j.issn.1673-8225.2012.05.003
肝移植治疗脾功能亢进相关终末期肝病
Liver transplantation for end-stage liver disease with hypersplenism
摘要
Abstract
BACKGROUND:Liver transplantation has become the most effective method to treat end-stage liver disease with hypersplenism.However, it is not certain that whether hypersplenism can occur when the speen is kept in the process of liver transplantation.OBJECTIVE: To observe the recovery of spleen function after liver transplantation in end-stage liver disease with hypersplenism.METHODS: Sixty-three cases of end-stage liver disease treated with liver transplantation were selected, and they were dividedinto two groups: hypersplenism group and non-hypersplenism group. Postoperative changes of the two groups in platelets,diameter from top to bottom measured by color ultrasound, intercostal thickness, splenic vein diameter at the portal vein wereobserved, and all the patients were followed-up for 15 months.RESULTS AND CONCLUSION: Of the 63 cases selected, eight cases died, and 55 cases were analyzed. Only one casesurvived in the four cases which underwent parallel splenectomy. When surgery ended, platelets level in the hypersplenism groupwas significantly lowe r than that before surgery, and decreased to its lowest point at day 3 after surgery, then gradually increased,obviously increased at day 7 (P < 0.05), and kept stable until month 15. Platelets level in the non-hypersplenism group dropped toits lowest point at day 5 after surgery, and reached the preoperative level at day 17. There were significant differences betweenthe two groups (P < 0.05). In the hypersplenism group at day 7 after surgery, spleen diameter from top to bottom and thicknessbegan to re duce significantly (P < 0.05); splenic vein diameter significantly reduced at month 3 (P < 0.05), and kept stable untilmonth 15. In the 55 cases, no case was found portal hypertension and variceal bleeding. These findings suggest that the speenshould be kept as far as possible in the process of liver transplantation if cases have no indications for splenectomy.关键词
脾功能亢进/肝移植/终末期肝病/门静脉/临床观察分类
医药卫生引用本文复制引用
方迎兵,江艺,吕立志,蔡秋程,张小进..肝移植治疗脾功能亢进相关终末期肝病[J].中国组织工程研究,2012,16(5):771-774,4.基金项目
2011年福建省科技项目计划(2011Y0046):肝移植术后感染状态下细胞免疫功能的实验及临床研究. （2011Y0046）
