資源描述：
《肝脾聯(lián)合切除術(shù)治療肝癌合并肝硬化脾功能亢進(jìn)的遠(yuǎn)期療效.doc》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在工程資料-天天文庫(kù)。
1、肝脾聯(lián)合切除術(shù)治療肝癌合并肝硬化脾功能亢進(jìn)的遠(yuǎn)期療效6?中華醫(yī)學(xué)雜志2004年1月2曰第84卷第lanedj里墜：肝癌及肝硬化研究.肝脾聯(lián)合切除術(shù)治療肝癌合并肝硬化脾功能亢進(jìn)的遠(yuǎn)期療效蔡建強(qiáng)胡敬群畢新宇趙建軍車旭解世亮邵永孚趙平【摘要】目的探討肝脾聯(lián)合切除術(shù)治療肝癌合并肝硬化脾功能亢進(jìn)的遠(yuǎn)期療效.方法對(duì)102例肝癌合并肝硬化脾功能亢進(jìn)患者的臨床資料進(jìn)行回顧性分析.57例行肝脾聯(lián)合切除術(shù)(A組),45例行單純肝切除術(shù)(B組).結(jié)果A,B兩組術(shù)中出血及術(shù)后并發(fā)癥的發(fā)生率差異均無(wú)顯著意義(P>0.05),但術(shù)后血小板,白細(xì)胞的回升及與肝硬化預(yù)后相關(guān)的指標(biāo)谷氨酰轉(zhuǎn)肽
2、酶(GGT)數(shù)值的改善,A組明顯好于B組(P<0.05).兩組1,3,5年復(fù)發(fā)率分別為27.1%,48.6%,69.3%及41.2%,50.0%,77.9%;生存率分別為92.6%,59」%,41.8%及80.3%,43.9%,29.1%，兩組雖然沒(méi)有統(tǒng)計(jì)學(xué)差異，但A組的生存情況均好于B組，而且A組復(fù)發(fā)患者的平均帶瘤生存期(12.9個(gè)月)亦明顯長(zhǎng)于B組(6.3個(gè)月,P<0.01).結(jié)論肝脾聯(lián)合切除術(shù)治療肝癌合并肝硬化脾功能亢進(jìn)不但具有良好的安全性且長(zhǎng)期隨訪的結(jié)果是滿意的.【關(guān)鍵詞】癌，肝細(xì)胞;肝硬化;脾功能亢進(jìn);肝脾聯(lián)合切除;預(yù)后Long-termef
3、fectofunitedhepateetomyandsplenectomyontreatmentothepatocellularcarcinoinacomplicatediSthcirrhosisandhypersplenismCAIJian―iang,HUJing?qun,BIXin—yu,ZHAOJian-jun,CHEXu,XIEShi-liang,SHAOrong-fu,ZHAOP,咎DepartmentofSurgicalOncology,CancerHospital,ChineseAcademyot'MedicalSciences,BeOing1000
4、21,China【Abstract]ObjectiveTodiscussthelong—termeffectofunitedliverandspleenresectionontreatmentof'hepatocellularcarcinoma(HCC)complicatedwithciiThosisandhypersplenism.MethodsrIlleclinicaldataof102patientsofHCCcomplicatedwitllciiThosisandhypersplenism.57ieceivingunitedhepatectomyandsp
5、lenectomy(groupA),and45receivinghepatectomyonly(groupB),wereretrospectivelyexamined.ResultsnevolumeofoperativebloodlossofgroupAwas765ml(100^2400ml),notsignificantlydifferentfromthatofgroupB(720ml,200^2000ml).operativemorbiditywas1.7%(l/57)ofgroupA,significantlyhigherlowerthanthatofgro
6、upB(4.4%,2/45).Aftertheoperation,山eplateletcountincreasedto275.8x!0/LingroupA,significantlyhigherthanthatingroupB(83x10/L.P<0.05);andthewhitebloodceilcountofgroupAincreasedto10.4x10/L,significantlyhigherthanthatofgroupB(4.19x10/L,P<0?05)?Post—perativegammaglutamyltransferase.apr
7、ognosticfactorforlivercirrhosis,ofgroupAwas68U/L,significantlylowerthanthatofgroupB(132U/L,P<O.O5).rI1leincidenceofcomplicationwas29.8%(17/57)ingi?oupA」】otsignificai】tlydiffei?entfromthatofgroupB(33?3%」5/45).rlIlel,3,and5-yeaiTecurrencerateswere27.1%,48.6%,and69.3%ingroupA,versus41
8、?2%，5
