摘要
目的探讨肝豆状核变性患者行外科辅助治疗的安全性及有效性。方法回顾性分析2001年至2008年安徽中医药大学第一附属医院收治的231名肝豆状核变性患者行外科辅助治疗的临床资料,针对手术前后临床数据进行对比分析,明确外科辅助治疗效果。所有患者均进行5年临床随访,了解术后恢复情况。结果本组资料中,172名患者行脾脏切除术,34名患者行脾脏切除联合贲门周围血管离断术,25名患者行门腔静脉分流术。术后患者白细胞、红细胞、血小板、胆红素、谷丙转氨酶与术前相比明显改善(P<0.05)。本组患者术后早期并发症79例,5例死亡,随访期间17例出现并发症。结论脾脏切除术是肝豆状核变性合并脾功能亢进患者的安全有效的治疗措施,但门体静脉分流术后并发症发生率高,需谨慎实施。
Objective The aim of this study was to investigate the effectiveness of surgical adjuvant intervention for patients with hepatolenticular degeneration. Methods Database of patients undergone surgical adjuvant treatment with Wilson＇ s disease was collected retrospectively during the 8-year period （2001-2008）. Outcomes between preoperative and postoperative biochemical indicator were compared retrospectively. The long-term results were collected after 60-month follow-up. Result In our series, 172 patients un- derwent splenectomy alone. Splenectomy with porta-azygos disconnection was carried out in 34 patients with Wilson＇ s disease and Portosystemic shunts were constructed in 25 patients. After surgical adjuvant procedure, the parameter of erythrocyte, leucocyte, thrombocyte, bilirubin and transaminase recovered to normal compared with preoperative data （ P 〈 0.05 ）. There were 79 complications within 2 weeks occurring in patients who underwent surgical adjuvant intervention and 5 patients died. Follow-up was conducted successfully in 209 patients and 17 patients occurred complications in postoperative period. Conclusion Spleneetomy could be an effective and safe management for patients with hepatolenticular degeneration concomitant with hypersplenism, but portosystemic shunts should be cautious for high morbidity.
出处
《肝胆外科杂志》
2014年第3期190-193,共4页
Journal of Hepatobiliary Surgery
基金
安徽中医药大学青年科学研究基金(2014qn021)
关键词
肝豆状核变性
外科辅助治疗
药物治疗
脾脏切除术
hepatolenticular degeneration
surgical adjuvant treatment
drug therapy
splenectomy
