| BackgroundsCirrhosis is a common clinical chronic liver disease,manifested aschronic hepatitis or other damage cause liver lobule destruction and normalliver tissue replaced by fibrous tissue.Advanced cirrhosis often leading todeath in patients with serious complications of upper gastrointestinalbleeding and hepatic encephalopathy.The upper gastrointestinal bleedingcaused by portal hypertension is the main cause of death in cirrhosis patients.Splenectomy with porta-azygous disconention procedure used for treatmentportal hypertension and reduce the incidence of upper gastrointestinalbleeding in clinical, however,it’s helpless for improvement of hepaticfunction.Cirrhosis induced hepatic functional reserve decreased isconsidered to be irreversible,liver transplantation considered the besttreatment option.However,the increasing shortage of donor livers,it’sexpensive costs and high technical requirements limited liver transplantation.Bone marrow stem cells with differentiation potential for a variety offunctional cells,which into the liver could become the liver cells to replace damaged liver cells,a large number of animal models and clinical studieshave confirmed it’s function as normal liver cells.The Bone marrow stemcells increase the functional liver volume,and improve liver function.Atpresent,autologous bone marrow stem cell transplantation(ABMSCT) fortreatment of liver cirrhosis has been widely used.Objectives30cases of cirrhosis patients who accord to splenectomy withporta-azygous disconnection indications were randomly divided into twogroups,15patients of ABMSCT group were treated by autologous bonestem cell transplantation jointed splenectomy with porta-azygousdisconention.Bone marrow stem cells were injected into the intrahepaticthrough the portal vein tributaries on the operation. The other15patients ofcontrol group only treated by splenectomy with porta-azygousdisconention.Detected and compared the change of alanine aminotransferase(ALT),total bilirubin(TBIL),albumin (ALB),prealbumin (PA),prothrombintime(PT) and the change of the ascites volume,Child-Pugh classificationchanges,comprehensive assessm-ent of their liver function.Discussion the treatment effect of autologous bonestem cell transplantation joint splenectomy with porta-azygous disconentioncompared to single splenectomy with porta-azygous disconention in thetreatment of decompensated cirrhosis.Materials and methods 1. sample origins30cases of hepatic cirrhosis patients admitted to ourhospital during January to August of2011.Diagnosised in accordance with<The programs of the prevention and treatment to viral hepatitis>.Diagnosisof child-Pugh classification C-class standards,The patients were satisfiedwith splenectomy devascularization surgical indications.Stem cell therapygroup15cases,11males and4females,average age(56±13).The controlgroup of15cases,10males and5females,average age(59±11).2. Approaches:Stem cell therapy group patients after general anesthesiain the posterior superior iliac spine acquisition of bone marrow blood of40-80mL, mononuclear cells(MSC) separated by Wilson stem cell mediumkit,cells counted for17.5×1010.After devascularization operation to exposethe portal vein,intraoperative infusion the MSC(contained bone marrowstem cells) to the Stem cell therapy group patient slowly through the portalvein at the speed of1mL/min.3.Curative effects:Continuous observation of ALT,TBIL,ALB,PA,PTand ascites volume of all patients after treatment.Liver volume in allpatients were analyzed and compared one month after surgery.4.Statistical treatment:The date was analyzed by SPSS19.0software.measurement data showed by(x±S).Data using the t test, P <0.05wasconsidered statistically significant.Results1.30cases of patients intraoperative observed narrow lobe of the liver volume,surface bulk in varying sizes hardened nodules of cirrhosis typicalperformance,spleen increased significantly enlarged splenic hilum,esophageal and gastric veins were varicose.Stem cell therapy group patientsintraoperative infusion the bone marrow stem cell suspension via the portalvein.2. The data analysis of the patients treated by autologous bone marrowstem cell transplantation combined with splenectomy and devascularizationand single treated by splenectomy and devascularization after one month areshown in Table1, Table2, Table3.3. The operation patients who treatment by stem cell transplantationhave not side effects such as vomiting,fever,allergic reactions anddiscomfort.ConclusionsThe treatment effect of autologous bone marrow stem celltransplantation combined with splenectomy and devascularization is betterthan single splenectomy devascularization. |
PDF Full Text Request