上海交通大学学报(医学版)

• 论著(临床研究) • 上一篇    下一篇

序贯疗法降低部分脾栓塞术后不良反应的临床研究

施敏1,王玉刚1,魏珏1,王霆1,孟文颖1,马骏2   

  1. 上海市同仁医院, 上海交通大学 医学院附属同仁医院 1.消化科, 2.重症医学科, 上海 200336
  • 出版日期:2016-06-28 发布日期:2016-07-25
  • 通讯作者: 马骏, 电子信箱: majun@shtrhospital.com。
  • 作者简介:施敏(1973—), 男, 副主任医师, 硕士; 电子信箱: shimingdyx@yeah.net。
  • 基金资助:

    上海市医学重点学科建设基金(ZK2015A24);上海市科委引导类基金(14411973700);上海市卫生和计划生育委员会科研课题(20134100)

Clinical analysis of sequential therapy with partial splenic embolization in decreasing postoperative adverse reactions

SHI Min1, WANG Yu-gang1, WEI Jue1, WANG Ting1, MENG Wen-ying1, MA Jun2   

  1. Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1.Department of Gastroenterology, 2.Department of Intensive Care Unit, Shanghai 200336, China
  • Online:2016-06-28 Published:2016-07-25
  • Supported by:

    Shanghai Municipal Health Bureau Key Disciplines Grant, ZK2015A24; Science Guide Foundation of the Science and Technology Commission of Shanghai Municipality, 14411973700; Shanghai Municipal Health Bureau, 20134100

摘要:

目的 探讨序贯疗法减少部分脾栓塞术(PSE)后不良反应的临床价值。方法 回顾98例肝硬化合并脾功能亢进患者病例资料,分为序贯PSE治疗组和PSE对照组(单次PSE),分析治疗前后血常规、肝功能、栓塞后综合征、术后并发症等相关情况。结果 2组白细胞和血小板治疗后2周、1个月分别与治疗前相比,均明显上升(P<0.01);序贯组重度疼痛及高热发生率明显低于对照组(P<0.01),重度疼痛、发热持续时间及住院天数相对较短 (P<0.01),术后并发症发生率也明显低于对照组(P<0.01)。结论 序贯PSE能有效改善脾亢症状,减少、减轻PSE术后不良反应。

关键词: 脾功能亢进, 序贯疗法, 栓塞, 治疗, 并发症

Abstract:

Objective To explore the clinical value of sequential therapy with partial splenic embolization (PSE) in reducing postoperative adverse reactions. Methods Medical data of 98 patients with portal hypertension complicated with hypersplenism were retrospectively reviewed, which were divided into the sequential group (sequential PSE) and the control group (single PSE). The results of routine blood test, liver function, and incidence rate of post embolization syndrom,and postoperative complications were analyzed in patients of the two groups before and after the treatment. Results Compared with those before the treatment, white blood cells and platelets were significantly increased 2 weeks and 1 months after the treatment (P<0.01). Incidence rate of moderate and severe pain and high fever of the sequential group was obviously lower than that of the control group (P<0.01). The duration of moderate and severe pain and fever, and hospitalization day of the sequential group were relatively shorter (P<0.01). And the incidence of postoperative complications of the sequential group was obviously lower than that of the control group (P<0.01). Conclusion Sequential PSE can effectively improve the symptom of hypersplenism, and reduce the postoperative adverse reactions and complications of PSE.

Key words: hypersplenism, sequential therapy, embolization, therapy, complication