病毒性肝炎肝硬化并脾功能亢进的治疗进展

病毒性肝炎肝硬化合并脾功能亢进是临床上常见的肝脏疾病,其产生的脾脏肿大占位效应和血细胞过度消耗及伴随骨髓移植等临床综合症状,严重影响了针对病毒性肝炎肝硬化的抗病毒治疗。目前通过非手术治疗难以控制脾脏肿大,且无特异性药物有效遏制,极易造成重度贫血和血小板减少症导致的出血现象,此时外科和介入治疗手段则为首选方式,一般包括脾脏切除、脾脏部分切除、介入治疗(目前以脾动脉栓塞为主)等,其中又以脾脏切除术疗效最直接和确切。然而脾切除对人体免疫功能的损害使人们认识到保脾的重要性,但如何最大限度的保留脾组织和脾功能,至今争议仍然存在。因此,本文综述了肝硬化脾功能亢进的发病原因及机制,脾亢的诊断标准以及脾功能亢进的外科和介入治疗方法,为脾功能亢进的研究提供一定的理论基础。

Advances in Therapy of Hepatitis c Cirrhosis with Hypersplenism

Spleen hyperthyroidism caused by viral hepatitis and cirrhosis is a common clinical liver disease, it often leads toenlarged spleen, excessive consumption of blood cells, bone marrow transplantation and other clinical syndrome, seriously influences theanti-viral therapy against viral hepatitis. Currently, non-surgical treatment is difficult to control the enlargement of the spleen, and thereare no specific drugs available, result in bleeding by severe anemia and thrombocytopenia. Compared with non-surgical treatment, thesurgical and interventional treatment, including splenectomy, spleen resection, intervention (splenic artery embolization), is more directand exact, especially of splenectomy. However, splenectomy is harmful to the immune function, it makes people aware of the importanceof spleen-preserving, but there are still disputes on how to maximize the retention of the spleen and splenic function. Here, we would firstreview the causes and mechanisms of hypersplenismin liver cirrhosis, then discuss the diagnostic criteria and treatment of hypersplenism,thus provide a theoretical basis for hypersplenismstudy.