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中华肝脏外科手术学电子杂志 ›› 2023, Vol. 12 ›› Issue (04) : 469 -473. doi: 10.3877/cma.j.issn.2095-3232.2023.04.022

所属专题: 综述

综述

乙肝后肝硬化门静脉高压症脾肿大外科治疗进展
许语阳, 吕云福, 王葆春()   
  1. 570311 海口,海南医学院附属海南医院(海南省人民医院)胃肠外科
  • 收稿日期:2023-01-31 出版日期:2023-08-10
  • 通信作者: 王葆春
  • 基金资助:
    海南省院士创新平台科研专项项目(YSPTZX202005)

Progress of surgical treatments for splenomegaly in patients with hepatitis B cirrhotic portal hypertension

Yuyang Xu, Yunfu Lyu, Baochun Wang()   

  • Received:2023-01-31 Published:2023-08-10
  • Corresponding author: Baochun Wang
引用本文:

许语阳, 吕云福, 王葆春. 乙肝后肝硬化门静脉高压症脾肿大外科治疗进展[J]. 中华肝脏外科手术学电子杂志, 2023, 12(04): 469-473.

Yuyang Xu, Yunfu Lyu, Baochun Wang. Progress of surgical treatments for splenomegaly in patients with hepatitis B cirrhotic portal hypertension[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(04): 469-473.

乙型病毒性肝炎(乙肝)后肝硬化的病理学特点是HBV引起肝脏慢性损伤后,肝脏组织学上出现再生结节,周围纤维带环绕,导致肝功能损害和门静脉高压症[1]。脾肿大合并脾功能亢进症(脾亢)和食管胃底静脉曲张是门静脉高压症患者的常见表现。脾肿大常与脾亢并行发展[2]。门静脉高压性脾肿大或脾亢,常常伴有外周血细胞减少,导致预后不良,脾切除术后这些血液成分的病理性改变消失[3,4]。脾肿大是乙肝后肝硬化门静脉高压症常见、多发和严重的并发症,目前临床上有多种外科手段能治疗该并发症,主要分为手术治疗和非手术治疗。本文综述了脾切除术、分流术、肝移植术等手术治疗和经颈静脉肝内门体静脉分流术(transjugular intrahepatic portosystemic shunt,TIPS)、脾动脉栓塞术(splenic artery embolization,SAE)、射频消融术(RFA)、微波消融术(microwave ablation,MWA)、高强度聚焦超声消融术(high intensity focused ultrasound ablation,HIFUA)等非手术治疗的研究进展。

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