重庆医学2013，Vol.42Issue(1)：24-26,30,4.DOI:10.3969/j.issn.1671-8348.2013.01.008
保留脾脏的选择性断流联合脾肾静脉桥式分流术对肝硬化合并门静脉高压患者免疫功能的影响
Effects of spleen-preserving selective devascularization followed by splenorenal venous bridge shunt operation on immune function of patients with cirrhosis and portal hypertension
李小珍 1罗地来 1朱程 1涂黄 1祝海锋 1邹书兵1
作者信息
- 1. 南昌大学第二附属医院肝胆外科,江西南昌,330006
- 折叠
摘要
Abstract
Objective To investigate effects of spleen-preserving selective devascularization followed by splenorenal venous bridge shunt operation on immune function of patients with cirrhosis and portal hypertension .Methods 51 cases of cirrhosis and portal hypertension were collected ,and divided into combination group (patient receiving spleen-preserving selective devascularization followed by splenorenal venous bridge shunt operation ,n=21) and devascularization group (patient receiving pericardial devascularization with splenectomy ,n=30) according to surgical procedures .Pre- and post-operative levels of leukocytes ,platelets ,immu-noglobulin(IgG ,IgA ,IgM ) and T lymphocyte subsets(CD4+,CD8+,CD4+/CD8+) in peripheral blood of patients in both groups were compared .Results Compared to pre-operation ,post-operative leukocytes and platelets in peripheral blood of patients in both groups increased(Ρ<0.05) .Platelets in peripheral blood of patients in devascularization group increased more than those in combi -nation group one week after operation (P<0.05) ,and platelets in both groups reached the normal range 4 weeks after operation with no statistical difference (P>0.05) .Compared to pre-operation ,post-operative IgM in peripheral blood of patients in combination group increased (P<0.05),and decreased,in devascularization group(P<0.05) .Compared to pre-operation ,post-operative CD4+ and CD4+ /CD8+ in peripheral blood of patients in devascularization group reduced (P<0.05) and CD4+ ,CD8+ ,CD4+/ CD8+ showed little change in combination group (P>0.05) .Post-operative CD4+ and CD4+ /CD8+ in peripheral blood of patients in combination group were higher than those in devascularization group (P<0.05) .Conclusion Treatment of portal hypertension with spleen-preserving selective devascularization followed by splenorenal venous bridge shunt operation can relieve patients from hypersplenism and improve their immune function .关键词
脾肾分流术,外科/高血压,门静脉/肝硬化/免疫球蛋白类/T淋巴细胞Key words
splenorenal shunt ,surgical /hypertension ,portal /liver cirrhosis /immunoglobulins /T-lymphocytes引用本文复制引用
李小珍,罗地来,朱程,涂黄,祝海锋,邹书兵..保留脾脏的选择性断流联合脾肾静脉桥式分流术对肝硬化合并门静脉高压患者免疫功能的影响[J].重庆医学,2013,42(1):24-26,30,4.
