【摘要】 目的 探讨自身免疫性肝炎后肝硬化伴脾功能亢进行脾切除术的治疗效果。方法对自身免疫性肝炎后肝硬化伴脾功能亢进9例患者行脾切除术及贲门周围血管断流术。结果 9例患者恢复良好,术后2周肝功能恢复到术前水平,手术前后转氨酶、胆红素变化差异无统计学意义(P>0.05),白细胞及血小板升至正常水平,较术前差异有统计学意义(P<0.05),脾功能亢进症状得到纠正,凝血功能较前明显好转,差异有统计学意义(P<0.05)。术后随访12~18个月无一例再发消化道出血,行贲门周围血管离断术术后3个月复查胃镜提示食道静脉曲张较前好转。结论脾切除及贲门周围血管断流术是自身免疫性肝炎后肝硬化失代偿期的一项有效措施,对改善患者脾功能亢进、提高患者的凝血功能,减少出血有较明显的作用。更多还原

【Abstract】 Objective To investigate the effect of splenectomy on autoimmune hepatitis complicated with cirrhosis and hypersplenism.Methods Nine cases of autoimmune hepatitis complicated with cirrhosis and hypersplenism were treated with splenectomy and periesophagogastric devascularization.Results All patients recovered well.Their liver functions recovered to the preoperative level within two weeks after operation.No significant differences were found between preoperative and postoperative levels of transaminase and bilirubin(P >0.05).The count of leukocyte and platelet rose to the normal level and there were significant differences between the preoperative and postoperative levels(P < 0.05).Patients’ symptoms of hypersplenism were corrected and their coagulation function improved significantly(P <0.05).Conclusion In patients with autoimmune hepatitis complicated with cirrhosis and hypersplenism,splenectomy with periesophagogastric devascularization is an effective procedure for improving hypersplenism,enhancing blood coagulation,and reducing bleeding.更多还原