tace联合部分脾动脉栓塞术对肝癌伴脾亢患者免疫功能影响word论文.docxVIP

摘要目的：探讨单纯 TACE 与 TACE 联合部分脾动脉栓塞术对肝癌伴脾功能亢进患 者免疫功能的影响。方法：所有 66 名入选病例，均通过影像资料及实验室检查明确诊断肝癌合并脾 功能亢进。随机分为两组，其中 TACE 组 35 例，TACE+PSE 组 31 例。TACE+PSE 组实施肝癌介入治疗同时行部分脾动脉栓塞术。观察指标为两组术前、术后的外 周血象、免疫学指标（细胞、体液免疫）及术后并发症的变化。结果：在 TACE+PSE 组, 术后血液中 WBC、PLT 升高与术前比较,均有显著性差 异( P 0.05)，术后 WBC、PLT 变化两组间比较均具有显著差异( P 0.05)；在 TACE+PSE 组, 术后 CD4+、CD8+、CD4+ /CD8+分别与术前比较, 均有显著性 差异( P 0.05).术后 7 d、术后 30d 血液中 CD4 +、CD8+及 CD4+/CD8+比较两组 间有显著差异( P 0.05). 在 TACE 组, 术后测 CD4 + 、CD8+及 CD4 + /CD8 + 分 别与术前比较, 均无显著性差异( P 0.05)；在 TACE+PSE 组术后 30d，血清内 IgA 含量升高与术前比较有显著性差异(P 0. 05)。两组术后 7d，血清内 IgM、IgG、 IgA 的含量与术前比较,均无显著差异 ( P0. 05) ,术后 30d 时血清内 IgM 、IgG 的含量与术前比较，均无显著差异 ( P 0. 05)；两组之间并发症(如：发热、胸 腔积液、腹水、腹痛等)的发生率比较均提示差异不具有显著性( P 0.05)。 结论：TACE 联合部分脾动脉栓塞术治疗肝癌合并脾亢，可以有效缓解脾功能亢 进、改善免疫功能、提高机体免疫力，且手术操作简单、安全，故有选择的实施 联合介入手术，可取得更加满意的临床诊疗效果，值得推广应用。 关键词：原发性肝癌脾功能亢进经皮动脉灌注化疗栓塞术部分脾动脉栓塞术免疫功能IAbstractObjective:To investigate the impact of TACE alone and TACE therapy combined with partial splenic embolization for hepatocellular carcinoma with hypersplenism patients immune function .Methods: A prospective study of patients 66 cases of hepatocellular carcinoma with hypersplenism ,sixty-six patient clinically diagnosedas hepatocellular carcinoma withhypersplenism were randomly divided into two groups: TACE groups（n=35）andTACE+PSE groups (n=31).the TACE+PSE group underwent PSE and transcatheter arterialchemoembolization (TACE). Before and after treatment, blood routineexami-nation was performed, and immunologic pa-rameters( Humoral immunity 、Cellular immunity ) were determined in both groups. Thecomplications associated with treatment were also observed.Results:In the TACE+PSE group, significant differences were noted in WBC and PLT (both P 0.05)between before and after treatment. Significant differences were noted inWBC and PLT (both P 0.05)after treatment,between two groups.Significantdifferences were noted inCD4+、CD8+lymphocyte percentage and CD4+ /CD8+ratio7 and 30days after treatment, between two groups.Sign