查詢結果分析
來源資料
相關文獻
- 肝硬化病人脾功能亢進症之治療:比較經導管脾動脈栓塞術與外科脾臟切除術之效果
- Pulmonary Function Changes in Cirrhotic Patients
- Recurrent Spontaneous Bacterial Empyema in Cirrhosis: A Case Report
- 肝硬化患者之細菌性感染--157位病例研究
- Isolated Fundic Varices in Liver Cirrhosis
- 肝硬化的病理治則機轉
- Can Advanced Hemostatic Parameters Detect Disseminated Intravascular Coagulation More Accurately in Patients with Cirrhosis of the Liver?
- Can the Screening Clotting Tests Predict the Complicated Hemostatic Changes in Patients with Cirrhosis of Liver?
- 壞死後肝硬化病患的營養評估
- 肝硬化腹水的治療
頁籤選單縮合
題名 | 肝硬化病人脾功能亢進症之治療:比較經導管脾動脈栓塞術與外科脾臟切除術之效果=The Treatment for Hypersplenism in Cirrhosis: Compare Transcatheter Splenic Artery Emobization with Total Surgical Splenectomy |
---|---|
作者 | 王蒼恩; 施壽全; 高進祿; 周孫衍; 林錫泉; 王鴻源; 朱正心; 楊斐適; Wang, Tsang-en; Shih, Shou-chuan; Kao, Chin-roa; Chou, Sun-yen; Lin, Shee-chan; Wang, Horng-yuan; Chu, Cheng-hsin; Yang, Fei-shih; |
期刊 | 內科學誌 |
出版日期 | 19970300 |
卷期 | 8:1 1997.03[民86.03] |
頁次 | 頁30-37 |
分類號 | 415.53 |
語文 | chi |
關鍵詞 | 肝硬化; 脾臟功能亢進症; 經導管脾臟動脈栓塞術; 外科脾臟切除術; Liver cirrhosis; Hypersplenism; Transcatheter splenic artery embolism; Surgical splenectomy; |
中文摘要 | 脾功能亢進是肝硬化併發症之一,伴隨著脾臟腫大, 血小板與 白血球減少,使原本已有凝血機能障礙的肝硬化病人更容易出血,因此有不 少方法用以處理此脾功能亢進,但是各家報告結果並不一致。其中經導管脾 動脈栓塞術和外科脾臟切除術使用最多,各有其優點與缺點。本文主要比較 這兩種方法的療效,與其治療後併發症發生的比率。採經導管脾動脈栓塞術 有16例,接受外科切除脾臟有8例,兩種方法在術後血小板與白血球數目 都呈有意義增加,所有病例在術後都會有疼痛與發燒現象,術後發燒天數接 受栓塞者明顯長於接受手術切除的病例,因為9.4天與4.2天。其它併發 症分別是十例與兩例,接受栓塞有兩例菌血症、四例肋膜腔積水,三例產生 腹水,兩例發生消化性潰瘍,手術治療發生消化性潰瘍與膿瘍各有一例。併 發症的發生以施術時及術後一兩週內發生機會較大,但統計學上兩種治療方 式並無有意義的差別,無法作下結論說那一種治療方法優於另外一種。另外 在長時間觀察後,本研究中兩種治療方式都能有效改善脾功能亢進的症狀, 且無重大併發症。因此經導管脾動脈栓塞術和外科脾臟切除術都能有效處理 肝硬化病人的脾功能亢進,應可依病人情況與醫院的能力做適當的選擇。 |
英文摘要 | Hypersplenism is one of the complications in patients with liver cirrhosis, in addition to splenomegaly, leukopenia and thrombocytopenia. Several different procedures have been used to treat hypersplenism, but with variable results. Transcutaneous splenic artery embolization (TSAE) and total surgical splenectomy have been reported to be of benefit in treating this complication. In this small series, we try to compare the two methods, and facus particularly on the complications. Retrospectively, we reviews liver cirrhosis cases who had received management for hypersplenism from 1985 to 1995. Sixteen of these cases had undergone TSAE and 8 patients had undergone surgical total splenectomy. The basic data for both groups showed no significant differences. Child's classification of the numbers of cases in two groups, prior to and 1 month after treatment was as follows: embolic group A12, B3, C1 & A12. B3, C1; surgical group A5, B2, C1 & A6, B1, C1. After treatment the leukocyte and platelet counts increased and no immediate mortality occurred in either group. Both methods were effective in treating hypersplenism in patients with cirrhosis The leukocyte count increase was greater in the surgical group. However almost all cases complained of pain and fever after the procedure. The average days of pain were 10.3 days in the TSAE group and 9.4 days in the surgical group and the duration of fever was 8.4 and 4.2 days, respectively. In the TSAE group, ten cases had complications; such as lung atelectasis, bacteremia, reflex ileus and ascites. 4 cases developed pleural effusion, and one case required chest tube drainage to remove the large amount of fluid. In the surgical group, only one case developed subphrenic abscess after operation and one had peptic ulcer. Patients with TSAE suffered more pain and had a poor response to analgesics. Both methods have long-lasting efficacy in controlling hypersplenism and didn't have sigificant complications in this series. The results of our small series suggests that TSAE may be an alternative method for cirrhosis patients with hypersplenism, but it is not superior to surgical splenectomy. TSAE and surgical resection can both to be used to treat the hypersplenism in cirrhosis patients to correct the hematologic abnormality and maintain a good effect over a period after the procedure. There-fore, either method can be chosen to manage patients, depending on the facility of the hospital and the wishes of patietns. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。