ABSTRACT
Objective:To investigate the clinical value of totally laparoscopic exclusion of splenic artery aneurysm combined with pericardial devascularization for portal hypertension com-plicated with splenic aneurysm.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 17 patients with portal hypertension complicated with splenic aneurysm who were admitted to 2 medical centers (15 cases in Shenzhen University General Hospital and 2 cases in Wuhan First Hospital) from January 2013 to May 2020 were collected. There were 7 males and 10 females, aged (59±14)years. All patients underwent totally laparoscopic exoclusion of splenic artery aneurysm combined with pericardial devascularization. Observation indicators : (1) surgical and postoperative conditions; (2) complications; (3) follow-up. Follow-up was conducted by out-patient examiantion and telephone interview to detect the effect of exclusion of arterial tumor, and blood re-flow, portal vein thrombosis and survival of patients 3 months after operation. The follow-up was up to December 2020. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Results:(1) Surgical and postoperative conditions. All 17 patients successfully completed the operation, without perioperative death. The operation time, volume of intraoperative blood loss of 17 patients were (181±30)minutes, 187(range, 90?420)mL. The white blood cell count, red blood cell count, hemoglobin, serum albumin were (9±4)×10 9/L, (3.5±0.9)×10 12/L, (86±17)g/L, (36±7)g/L on the postoperative day 3. Time to postoperative abdominal drainage tube removal and duration of post-operative hospital stay were (7±4)days and (11±4)days. (2) Complications. All 17 patients had ascites after surgery, which were improved after oral treatment with diuretics. There was no complication such as intra-abdominal hemorrhage, gastrointestinal fistula, pleural effusion, infection, abscess formation, fever and vascular embolism. (3) Follow-up. All the 17 patients were followed up for 28.6(range, 7.0?84.0)months. During the follow-up, the splenic aneurysm cavity of all patients was completely isolated, no blood re-flow and no portal vein thrombosis was observed, and no patient died. Conclusion:Totally laparoscopic exclusion of splenic artery aneurysm combined with pericardial devascularization is safe and feasible in the treatment of portal hypertension complicated with splenic aneurysm.
ABSTRACT
Objective To study the changes of serum albumin and its relationship with B-Type Natriuretic Peptide(BNP),High sensitivity C-reactive protein(hs-CRP)and left ventricular ejection fraction (LVEF) in patients with acute myocardial infarction(AMI).Methods Serum levels of albumin,BNP,hs-CRP at baseline were analyzed in 95 patients with AMI,and LVEF were measured by echocardiography.All AMI patients were divided into 2 groups based on the values of serum albumin:the hypoalbuminemia group and the normal albuminemia group.Fifty patients without coronary artery disease were selected as controls.The correlations between serum albumin and BNP,hs-CRP,LVEF were analyzed.Results Serum albumin in AMI patients was lower than that in the controls[(38.45±4.60) g/L vs.(43.15±3.11) g/L ;t =8.53,P < 0.001].BNP and hs-CRP levels in the hypoalbuminemia group were higher than that in the normal albuminemia group [(5.24±1.71)ng/L vs.(4.17±1.61) ng/L;t =2.660,P =0.009;(1.64±0.93) mg/L vs.(1.13±1.03)mg/L;t =2.159,P =0.045].LVEF in hypoalbuminemia group was lower than that in the normal albuminemia group[(49.10±11.63) % vs.(54.63±9.60) % ; t =2.268,P =0.025].Levels of serum albumin were negatively correlated with BNP and hs-CRP in AMI patients(r =-0.465,P <0.001 ; r =-0.391,P < 0.001).Levels of BNP were positively correlated with hs-CRP(r =0.492,P < 0.001).LVEF was negatively correlated with BNP values(r =-0.371,P < 0.001).Conclusion Hypoalbuminemia is associated with the prognosis of AMI and may be an important predictor of adverse outcome in patients with it.