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目的:探讨肝癌联合脾切除术治疗原发性肝癌合并脾功能亢进的效果及可行性。方法:将56例原发性肝癌合并脾功能亢进患者分为联合组及对照组各28例,分别行肝肿瘤联合脾切除术及单纯肝肿瘤切除术。比较2组手术前、后血常规改变,手术后近、远期并发症及术后5a无瘤生存率,判断手术安全性及病例选择对手术影响。结果:肝癌切除+脾切除组血小板、白细胞计数明显升高。结论:对原发性肝癌并脾功能亢进患者行一期肿瘤联合脾切除术可促进外周血白细胞和血小板恢复正常,改善患者免疫机能,且不增加手术风险。
Objective: To investigate the efficacy and feasibility of hepatocellular carcinoma combined with splenectomy in the treatment of primary hepatocellular carcinoma complicated with hypersplenism. Methods: Fifty-six patients with primary hepatocellular carcinoma complicated with hypersplenism were divided into the combined group and the control group with 28 cases in each group. Liver cancer combined with splenectomy and hepatic tumor resection were performed respectively. The changes of blood routine before and after operation were compared between the two groups. The postoperative short-term and long-term complications and the survival rate of postoperative 5a were compared to determine the safety of the operation and the influence of the case selection on the operation. Results: The number of platelets and white blood cells in hepatectomy + splenectomy group was significantly increased. CONCLUSIONS: Primary tumor and hypersplenism in patients with primary hepatocellular carcinoma can lead to the normal return of peripheral white blood cells and platelets and the improvement of immune function without increasing the risk of surgery.