不同治疗方法对肝癌合并脾功能亢进疗效研究

《不同治疗方法对肝癌合并脾功能亢进疗效研究》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、不同治疗方法对肝癌合并脾功能亢进疗效研究［摘要］目的探讨不同方法治疗肝癌合并脾功能亢进患者的临床疗效和意义。方法回顾性分析2007〜2010年收治的63例肝癌合并脾功能亢进患者的临床资料，其中，26例行单纯肝癌切除术（I组），18例行肝切除同时联合脾切除或脾动脉结扎（II组），19例行术前部分性脾栓塞（partialsplenicembolization,PSE）联合肝切除（III组）。观察3组治疗前后外周血细胞变化情况，分析围术期出血、输血和并发症等情况，比较各组1、3年总生存率。结果联合手术组术后外周血白细胞、血小板均较单纯手术组明显改善，与术前PSE组无

2、明显差异。术前PSE组患者出血量和输血量均较II组和I组明显减少（P<0.05）。联合手术组和术前PSE组的术后并发症明显低于单纯手术组患者，I、II和III组患者1、3年总生存率分别为：68.5%、38.1%,82.8%、52.6%和85.5%.56.3%,I组患者显著低于II组和III组（P<0.05）o结论肝脾联合手术和术前PSE是治疗肝癌合并脾功能亢进安全、有效的方法。术前PSE治疗更适合严重的门脉高压、巨脾、老龄和体质差患者。［关键词］肝癌；脾功能亢进；肝切除；脾切除；部分性脾栓塞［中图分类号］R735.7［文献标识码］A［文章编号］1674-472

3、1(2012)07(c)-0046-03ClinicalanalysisofdiversetreatmentforhepatocellularcarcinomawithhypersplenismLINZhiqianglYUWushenglLUChunlilLUHuanquanlHUXiaronglWUZhiminglYINYongshuolWANGZaiguolWEIWei2GUORongping21.DepartmentofOncologySurgery,DongguanPeople"sHospital,Dongguan523018,China；2.Depa

4、rtmentofHepatobilliaryOncology,CancerCenterofSunYat-senUniversity,Guangzhou,510060,China［Abstract］ObjectiveToevaluatetheefficacyofdiversetreatmentforhepatocellularcarcinomawithhypersplenism.MethodsTheclinicaldataof63patientsofhepatocellularcarcinomawithhypersplenismfrom2007to2010wer

5、eretrospectivelyanalyzed,26patientsonlyacceptedhepatectomy(groupI),18patientsacceptedhepatectomyincombinationwithsplenectomyorsplenicarteryligation(groupII),and19patientsunderwentpartialsplenicembolization(PSE)beforeoperation(groupIII).Theplatelets,whitebloodcells,complication,intro

6、-opera.tivebloodlossandtransfusionrequirementandsurvivalwereanalyzedretrospectively.ResuItsTheWBCandPLTcountsinthebloodsamplesofthePSEgroupwerehigherthanthoseinthesingleoperationgroupafteroperation.TherewerenosingnificantdifferencesintheWBCandPLTcountsbetweenthePSEgroupandthecombine

7、dgroup・Intro-operativebloodlossandtransfusionrequirementinthePSEgroupwerelowerthaninthesingleoperationgroupandthecombinedgroup(P<0.05).PostoperativecomplicationsinthePSEgroupandthecombinedgroupweresignificantlylessthanthatinthesingleoperationgroup・The1-yearand3-yearsurvivalrateswere

8、68.5%and38.1%forgro