| Objectives: To compare the effect of surgical and non-surgical treatment on hepatocirrhosis patients with portal hypertension and splenomegaly.Methods: A total of 200 patients with hepatocellular cirrhosis and portal hypertension with splenomegaly hospitalized in our hospital from January 2007 to February 2023 were retrospectively collected,including 99 patients in the surgical treatment group and 101 patients in the non-surgical treatment group.Gender,age,first diagnosis bleeding,Child-Pugh grade,the degree of esophagogastric fundus varices under gastroscopy,hepatic encephalopathy,ascites,treatment methods,blood routine,liver function,coagulation function,renal function,infection,overall treatment results,length of hospital stay and treatment cost of the two groups were analyzed and compared.Results: There were no significant differences between the two groups in gender,age,bleeding at first diagnosis and the degree of esophagogastric fundus varices under gastroscopy(P>0.05).The Child-Pugh grades(grade A 61.6%,grade B 33.3%,grade C 5.1%),hepatic encephalopathy(0%,but not 100%)and ascites(7.1%,but not92.9%)in the surgical treatment group were significantly better than those in the non-surgical treatment group(grade A 25.7%,grade B 60.4%,grade C 13.9%),(35.6%,but not 64.4%)and(46.5%,but not 53.5%)(P<0.05).After treatment,WBC count(9.19 ± 4.73 10E9/L),RBC count(3.65 ± 0.78 10E12/L),PLT count(327.02 ±200.21 10E9/L)and HB count(97.99 ± 16.09 g/L)in the surgical treatment group were significantly higher than those in the non-operative group(4.98 ± 2.77 10E9/L),(3.20 ± 0.74 10E12/L),(92.29 ± 62.10 10E9/L)and(91.11 ± 23.85 g/L)(P<0.05);ALT(42.58 ± 29.68 U/L),AST(54.21 ± 38.74 U/L),TP(64.31 ± 8.66 g/L),ALB(34.25 ± 4.27 g/L)and PA(91.73 ± 38.46 mg/L)in the operation group was significantly higher than that in the non-operative treatment group(33.30 ± 33.36U/L),(43.62 ± 24.35 U/L),(58.96 ± 8.19 g/L),(29.62 ± 4.92 g/L)and(71.44 ± 42.43mg/L)(P<0.05);The TT in the operative group(17.64 ± 7.75 s)was significantly longer than that in the non-operative group(16.71 ± 2.68 s)(P<0.05).The FIB of the operative group(2.60 ± 1.24 g/L)was higher than that of the non-operative group(2.08 ± 0.94 g/L)(P<0.05);PT(17.11 ± 4.86s),APTT(39.34 ± 19.46s)and creatinine(59.68 ± 26.60 umol/L)in the operative group were higher than those in the non-operative group(17.89 ± 4.11s),(46.10 ± 7.30 s)and(77.69 ± 81.77 umol/L)decreased significantly(P<0.05);The abdominal infection in the operative group(2.0%)was significantly lower than that in the non-operative group(20.8%)(P<0.05);There were no significant differences in pulmonary infection and systemic infection between the two groups(P>0.05);The overall treatment outcome of the operative group(cured 65.7%,improved 26.3%,no recovery 6.0%,death 2.0%)was significantly better than that of the non-operative group(cured 0%,improved 89.1%,no recovery 10.9%,death 0%)(P<0.05);The length of hospital stay in surgical treatment group(35.60 ± 20.92 days)was significantly longer than that in non-surgical treatment group(14.01 ± 5.80 days)(P<0.05);The treatment cost of surgical treatment group(66893.94 ± 52991.80 yuan)was significantly less than that of non-surgical treatment group(86225.75 ± 53868.45 yuan)(P<0.05).Conclusion: Compared with non-surgical treatment,surgical treatment can significantly improve peripheral blood cell count,coagulation function and kidney function,less possibility of abdominal infection,less treatment cost,can improve the short-term cure rate,and provide a certain basis for future clinical treatment selection. |
PDF Full Text Request