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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.
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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.