Treatment research progress of cirrhosis of the liver decompensation period, the splenic function and thrombocytopenia after hepatitis C / 中国综合临床

HCV-related decompensated cirrhos,hypersplenism,thrombocytopenia,which not only affect the standard antiviral therapy,fail to achieve the sustained virological response(SVR),but also increase the risk of infection and bleeding.The only successful option is liver transplantation (LT),but the recurrence of HCV after LT remains to be resolved.The patients of HCV genotype 2 are suitable for splenectomy and antiviral therapy following splenectomy,which can achieved a higher SVR and reversed cirrhosis.As an effective alternative to splenectomy,the partial splenic embolization (PSE) can improve the changes of portal hemodynamics and reduce the sequelae of portal hypertension.The appearance of direct antiviral drugs (DAAs)has bring hope for those with decompensated cirrhos and whom IFN is contraindicated or tolerated poorly,those who are waiting for LT or with recurrence of hepatitis C after LT.The treatment of patients with decompensated cirrhos is as follows.

Double intervention laparoscopic resection of the spleen schistosomiasis compounds with cirrhosis of the liver function of spleen hyperthyroidism clinical observation / 中国医师杂志

Objective To explore the internal jugular vein liver inside door body bypass surgery (Transjugularintrahepatie portosystemic shunt,TIPS) and part of the spleen embolization (PaniM splenicembolization,PSE) after laparoscopic resection combined with spleen schistosomiasis compounds with cirrhosis of the liver function of spleen hyperthyroidism curative effect.Methods Fifty-two cases had schistosomiasis hepatocirrhosis with spleen function in patients with hyperthyroidism,doing any operation after a week PSE TIPS.Postoperative liver function and adopted to monitor changes,two weeks left hand done help type laparoscopic splenectomy.Results Fifty-two patients underwent TIPS and PSE after surgical treatment,blood picture and liver function back to normal,in two weeks or so do help laparoscopic resection of the hand of the spleen,five cases were transfered to open surgery,patients were cured and discharged.And the previous similar average hospitalization days compared with patients who shorten,average hospital expenses dropped,and less complications,little pain.Conclusion TIPS and PSE joint laparoscopic splenectomy are schistosomiasis compounds with cirrhosis of the liver function of spleen hyperthyroidism,definite effect not only,and safety,minimally invasive,has a good value of clinical application.