自体脾移植及食管横断吻合术治疗肝硬化门脉高压症远期疗效.docVIP

自体脾移植及食管横断吻合术治疗肝硬化门脉高压症远期疗效[摘要] 目的：探讨腹膜后自体脾移植联合食管横断术治疗肝硬化门脉高压症（PHT）的远期疗效。方法：186例肝硬化门静脉高压症患者，行自体脾移植联合食管横断术治疗。观察其术后远期（2.3~25.2年）一般状况、并发症。测定血清Tuftsin水平、IgM水平、血常规、肝纤维化指标及肝功能的变化，用99ｍ Tc 及3D DEC MRA行脾扫描了解移植脾成活及其侧枝血管的建立。结果：术后一般状况良好，远期并发症无明显增加。全血细胞减少均得到完全纠正，肝功能及肝纤维化指标正常；血清Tuftsin及IgM水平，与术前水平无明显差异。结论：自体脾移植及食管横断吻合术，可作为门静脉高压症常规治疗的选择。 [关键词] 自体脾移植；门静脉高压症；远期疗效 [中图分类号]R657.3 [文献标识码]C [文章编号]1673-7210（2007）08（c）-145-02 The long-term prognosis of spleen autotransplantation combined with lower esophagus transection in the treatment of hepatic cirrhosis complicated with portal hypertension HUO Jing-shan1, CHEN Ji-sheng2, WU Zhuo2,CHEN Ru-fu2 （1.Chinese Medical Hospital of Fo Shan,Fo Shan 528000,China;2.Sun Yat-Sen Memorial Hospital of SunYat-Sen University, Guangzhou 510120, China）. [Abstract] Objective：To study the long-term prognosis of spleen autotransplantation in retroperitoneum combined with lower esophagus transection in the treatment for hepatic cirrhosis induced portal hypertension. Methods：106 cases of portal hypertension were treated by pleen autotransplantation in retroperitoneum combined with lower esophagus transection. The general condition、spleen scanning (by 99ｍTc and 3D DEC MRA)、blood routine、 liver function、index of liver fibrosis、 serum Tuftsin and IgM levels were observed and compared with those before operation. Results：After operation, the patients’ general condition was well. Long-term complications had no increase. Blood routine and liver function became normal. Serum Tuftsin, index of liver fibrosis and IgM levels had no change. Retroperitoneal transplanted spleen had extensive collateral circulation. Conclusion：Spleen autotransplantation combined with lower esophagus transection in the treatment of hepatic cirrhosis complicated with portal hypertension should be regarded as a main routine choose. [Key words] Spleen autotransplantation； Portal hypertension； Long-term prognosis 我们对1979年10月～2007年2月收治的186例腹膜后自体脾移植联合食管横断吻合术治疗肝硬化门静脉高压症(porta