|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Management of hypersplenism in non-cirrhotic portal hypertension:a surgical series显示文摘BACKGROUND:Hypersplenism is commonly seen in patients with non-cirrhotic portal hypertension(NCPH).While a splenectomy alone can effectively relieve the hypersplenism,it does not address the underlying portal hypertension.The present study was undertaken to analyze the impact of shunt and non-shunt operations on the resolution of hypersplenism in patients with NCPH.The relationship of symptomatic hypersplenism,severe hypersplenism and number of peripheral cell line defects to the severity of portal hypertension and outcome was also assessed.METHODS:A retrospective analysis of NCPH patients with hypersplenism managed surgically between 1999 and 2009 at our center was done.Of 252 patients with NCPH,64(45 with extrahepatic portal vein obstruction and 19 with non-cirrhotic portal fibrosis) had hypersplenism and constituted the study group.Statistical analysis was done using GraphPad InStat.Categorical and continuous variables were compared using the chi-square test,ANOVA,and Student's t test.The MannWhitney U test and Kruskal-Wallis test were used to compare non-parametric variables.RESULTS:The mean age of patients in the study group was 21.81±6.1 years.Hypersplenism was symptomatic in 70.3% with an incidence of spontaneous bleeding at 26.5%,recurrent anemia at 34.4%,and recurrent infection at 29.7%.The mean duration of surgery was 4.16±1.9 hours,intraoperative blood loss was 457±126(50-2000) mL,and postoperative hospital stay 5.5±1.9 days.Following surgery,normalization of hypersplenism occurred in all patients.On long-term followup,none of the patients developed hepatic encephalopathy and 4 had a variceal re-bleeding(2 after a splenectomy alone,1 each after an esophago-gastric devascularization and proximal splenorenal shunt).Patients with severe hypersplenism and those with defects in all three peripheral blood cell lineages were older,had a longer duration of symptoms,and a higher incidence of variceal bleeding and postoperative morbidity.In addition,patients with triple cell line defects had elevated portal pressure(P=0.001),portal biliopathy(P=0.02),portal gastropathy(P=0.005) and intraoperative blood loss(P=0.001).CONCLUSIONS:Hypersplenism is effectively relieved by both shunt and non-shunt operations.A proximal splenorenal shunt not only relieves hypersplenism but also effectively addresses the potential complications of underlying portal hypertension and can be safely performed with good long-term outcome.Patients with hypersplenism who have defects in all three blood cell lineages have significantly elevated portal pressures and are at increased risk of complications of variceal bleeding,portal biliopathy and gastropathy. | Rajesh Rajalingam Amit Javed Dharmanjay Sharma Puja Sakhuja Shivendra Singh Hirdaya H Nag Anil K Agarwal | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，2： | 7 |
| 2 | Carrot embryogenesis from frozen cultured cells 显示文摘 | Nag K K Street H E | 1973 | Nature1973，245，： | 1 |
| 3 | Calcitonin receptor-like receptor (CLR) influences posttranslational events of receptor activity-modi- fying proteins (RAMPs)显示文摘 | Nag K Sultana N H irose S | 2012 | Biochem Bioph Res Co2012，418，4： | 1 |
| 4 | Carrot embryogenesis from frozen cultured cells 显示文摘 | Nag K K Street H E | 1973 | Nature1973，245，： | 1 |
| 5 | A Chemical Kinetic Modeling Study on the Mechanism of Soot Reduction by Oxygenated Additives in Diesel Engines显示文摘 | Nag P Song K H Litzinger T A | 2001 | Int J Engine Research2001，2，3： | 1 |
| 6 | Carrot embryogenesis from fro- zen cultured ceils 显示文摘 | NAG K K STREET H E | 1973 | Nature1973，245，5： | 1 |
| 7 | Slime production is essential for the adherence of Staphylococcus epidermidis in implant-related infections显示文摘 | Nayak N Satpathy G Nag H L | 2011 | J Hosp Infect2011，77，2： | 1 |
| 8 | Isolation and character- ization of outer root sheath melanocytes of human hair follicles 显示文摘 | NAG Y PAEK S H PARK B C | 2006 | Br J Dermatol2006，155，90： | 1 |
| 9 | Carrot embryogenesis from frozen cultured cells显示文摘 | street H E | 1973 | Nature1973，245，： | 1 |
| 10 | Carrot embryogenesis from frozen cultured cells显示文摘 | Nag K K Street H E | 1973 | Nature1973，245，： | 1 |
| 11 | Carrot embryogenesis from frozen cultured cells显示文摘 | NAG K K STREET H E | 1973 | Nature1973，245，： | 1 |
| 12 | Excess attenuation of leaky Lame waves due to viscous fluid loading显示文摘 | NAYFEH A H NAG P B | 1997 | Journal of the Acoustical Society of America1997，101，5： | 1 |
| 13 | Proposed guidelines for image-based intracavitary brachytherapy for cervical carcinoma:report from Image-guided Brachytherapy Working Group显示文摘 | Nag S Cardenes H Chang S Image-guided Braehytherapy Working Group | 2004 | Int J Radiat Oncol Biol Phys2004，60，： | 1 |
| 14 | Advanced forecasting of cost and yield 显示文摘 | NAG P K MALY W JACOBS H | 1998 | Semiconductor International1998，21，8： | 1 |
| 15 | Differential expression of vascular endothelial growth factor - A ( VEGF - A) and VEGF - B after brain injury显示文摘 | Nag S Davis J James H | 2002 | J Neuropathol Exp Neurol2002，61，9： | 1 |
| 16 | Enhancing homeland security with advanced UWB sensors显示文摘 | Withington P Fluhler H and Nag S | 2003 | IEEE Microwave Magazine2003，4，3： | 1 |
| 17 | Strengthening mechanisms in Ti-NbZr-Ta and Ti-Mo-Zr-Fe orthopaedic alloys显示文摘 | BANERJEE R NAG S STECHSCHULTE J FRASER H L | 2004 | Biomaterials2004，25，： | 1 |
| 18 | Hydrodesulfurization of Polycycleic Aromatics Catalyzed by Sulfided Co - Mo/Al2O3 :The Reactivitve Reactivities 显示文摘 | Nag N K Sapre A V Broderick D H Gates B C | 1979 | J Catal1979，57，： | 1 |
| 19 | Microstructural evolution and strengthening mechanisms in Ti-Nb-Zr-Ta,Ti-Mo-Zr-Fe and Ti-15Mo biocompatible alloys显示文摘 | NAG S BANERJEE R FRASER H L | 2005 | Mater Sci Eng C2005，25，： | 1 |
| 20 | Carrot embryogenesis from frozen cultured cells显示文摘 | NAG K K STREET H E | 1973 | Nature1973，245，6： | 1 |
您所在的机构暂未开通此部分的功能，请联系管理员