| Objective To evaluate the short-term and long-term efficacy of splenectomy in patients with Wilson's disease and hypersplenism. Methods The clinical data of 130 patients with WD with hypersplenism who attended the Affiliated Hospital of the Institute of Neurology of Anhui University of Traditional Chinese Medicine from January 2018 to December 2024 was retrospectively analyzed, and the patients were divided into two groups according to whether splenectomy was performed, including 30 patients in the splenectomy group and 100 patients in the splenectomy group. The differences in general information and clinical characteristics between the two groups were compared. The blood counts, liver function, liver fibrosis, portal hypertension and neurological function before surgery, short-term(≤3 months) and longterm(≥1 year) after surgery were collected, and the changes in efficacy at different follow-up time points before and after surgery were compared. Secondly, the propensity score matching(PSM) was used to balance the baseline differences between the long-term splenectomy group and the spleen-sparing group at the same time, and the blood counts, liver function Child-Pugh score, Chinese version of the Unified WD Rating Scale(UWDRS) scores and complications were compared between the splenectomy group and the splen-sparing group. Results In the splenectomy group, PLT, RBC, WBC, NEUT, and Hb significantly increased in the short-term and long-term postoperative period compared with those before surgery(P<0.05). The long-term liver function after surgery, Child-Pugh score, HA, CⅣ, portal vein diameter, and pSWE were significantly improved compared with those before surgery(P<0.01), and the UWDRS score was reduced compared with that before and after surgery(P<0.05). After PSM matching, the long-term blood count, Child-Pugh score and control of cirrhosis complications in the splenectomy group were better than those in the spleen-sparing group(P<0.05), and there was no significant difference in UWDRS scores between the two groups(P>0.05). Conclusion The efficacy of splenectomy in patients with WD and hypersplenism is clear: short-term significant alleviation of hypersplenism, long-term continuous improvement of liver function, alleviation of liver fibrosis process, and reduction of the risk of complications of cirrhosis. |
