细针穿刺定位在射频消融治疗脾功能亢进症的应用

目的：探讨细针穿刺定位技术在CT引导下冷循环射频消融（RFA）治疗肝硬化门脉高压性脾功能亢进症（脾亢）的作用和经验。方法：22例脾亢患者在CT引导下行射频消融术,术中先用定位细针穿刺脾脏,然后参照细针位置,再以射频电极穿刺脾脏,确认射频电极位置正确后进行射频消融治疗。术后复查血常规和增强CT或MR以了解血小板（PLT）的变化和脾脏的消融体积。结果：射频电极穿刺总成功率为100%,其中第1次穿刺成功18例,第2次穿刺成功4例,脾脏消融体积为（40.0±5.6）%,术后1个月PLT（105±11）×109/L,与术前PLT（45.0±9.8）×109/L相比显著增高（P〈0.05）。没有因为穿刺失误导致的严重并发症发生。结论：应用细针穿刺定位技术,可以提高脾脏射频消融中穿刺的安全性,减少穿刺相关并发症的发生,值得进一步研究和总结。

The application of position fixing with a fine needle in the treatment of radiofrequency ablation for hypersplenism

Objective: To investigate the effect and experience of the technology of position fixing with a fine needle in the treatment of CT-guided radiofrequency ablation(RFA) with cool-tip electrode for hypersplenism in patients with liver cirrhosis and portal hypertension.Methods: 22 patients with the disease were treated by CT-guided RFA with cool-tip electrode.We used a fine needle to puncture the spleen first,and then we used the cool-tip electrode to puncture the spleen guided by the fine needle.Finally we con...