本文選題：門脈高壓 + 脾功能亢進��； 參考：《青海大學》2017年碩士論文

【摘要】：目的:探討TIPS聯(lián)合PSE對肝硬化門脈高壓合并脾亢患者門脈血流動力學改變及機體免疫調(diào)節(jié)的影響。方法:所有入選66例病例,均通過入組標準及排除標準遴選,半隨機分為兩組,其中TIPS+PSE組36例,TIPS組30例。觀察指標分別為術前、術后7d、30d患者門靜脈流速及直徑、分流道流速、外周血象、T細胞亞群、體液免疫功能指標。結果:TIPS+PSE組與TIPS組比較:術后30d分流道流速、門脈主干流速、門脈主干直徑無統(tǒng)計學差異(P0.05);TIPS+PSE組與TIPS組血WBC比較:術后7d及術后30d具有統(tǒng)計學差異(P0.05),TIPS+PSE組,術后1d、7d、30d與術前比較具有統(tǒng)計學差異(P0.05);TIPS+PSE組與TIPS組PLT比較:術后7d及術后30d具有統(tǒng)計學差異(P0.05),TIPS+PSE組術后7d、30d與術前對照差異具有顯著性(P0.05)。TIPS+PSE組與TIPS組CD3、CD4、CD8、CD4/CD8比較:術后7d及術后30d具有統(tǒng)計學差異(P0.05),TIPS+PSE組CD3、CD4、CD8、CD4/CD8術后7d及術后30d與術前比較具有統(tǒng)計學差異(P0.05)。TIPS+PSE組與TIPS組IgA、IgM、IgG比較:術后30d具有統(tǒng)計學差異(P0.05),TIPS+PSE組IgA、IgM、IgG術后30d與術前1d比較具有統(tǒng)計學差異(P0.05)。TIPS+PSE組與TIPS組術后并發(fā)癥比較均無統(tǒng)計學差異(P0.05)。結論:TIPS聯(lián)合PSE治療肝硬化門脈高壓合并脾亢,創(chuàng)傷小,安全性高,改善了門靜脈血流,有效緩解患者脾功能亢進癥狀、提高外周血白細胞及血小板水平、改善機體細胞及體液免疫功能。
[Abstract]:Objective: to investigate the effect of TIPS combined with PSE on portal hemodynamics and immune regulation in patients with cirrhosis and portal hypertension complicated with hypersplenism. Methods: all 66 cases were randomly divided into two groups, including 36 cases in TIPS PSE group and 30 cases in Tips group. The parameters were portal vein velocity and diameter, shunt velocity, peripheral blood T cell subsets and humoral immune function. Results compared with TIPS group, there was no significant difference in shunt velocity and portal trunk diameter between PSE group and TIPS group 30 days after operation. There was no significant difference in the diameter of portal trunk between PSE group and TIPS group. There was a significant difference in WBC between PSE group and TIPS group on the 7th day after operation and 30 day after operation. There was significant difference in PLT between the PSE group and the TIPS group on the 1st day and the 7th day after operation. There was a significant difference between the 7 days after operation and the 30 days after the operation. There was a significant difference between the PSE group and the TIPS group on the CD3 CD4CD _ 4 ~ (8) CD _ 4 / CD _ 8: 7 days after the operation, there was a significant difference between the three groups (P < 0.05) and the control group (P < 0.05). There was a significant difference between the PSE group and the TIPS group in terms of CD4 / CD _ 8: 7 days after the operation, there was a significant difference between the PSE group and the TIPS group. There was statistical difference between the 30 days after operation and the 30 days after operation. There was statistical difference between the three groups (P0.05TIPS PSE group) on the 7th day after the operation and the 30 days after the operation compared with the preoperative group. There was a statistical difference between the PSE group and the TIPS group on the 30th day after the operation. There was a statistical difference between the 30 days after the operation and the 1d before operation in the group of P0.05TIPS PSE. There was no significant difference in postoperative complications between the tips PSE group and the TIPS group. Conclusion the treatment of liver cirrhosis with portal hypertension with hypersplenism combined with PSE has little trauma and high safety. It can improve the portal vein blood flow, relieve the symptoms of hypersplenism, and increase the level of peripheral blood leukocytes and platelets. Improve cellular and humoral immune function.
【學位授予單位】：青海大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R575.2

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