部分性脾动脉栓塞治疗脾功能亢进的疗效观察

目的探讨部分性脾动脉栓塞术(PSE)取代传统的脾切除术,治疗肝炎后肝硬化并发脾功能亢进的疗效。方法收集12例被诊断为乙型肝炎后肝硬化的患者,CT或B超确诊为脾肿大,外周血象三系血细胞减少,采用改良Seldinging技术,经导管动脉栓塞部分脾动脉,术后观察红细胞、白细胞、血小板、脾脏厚度、脾动脉血流量、脾及门静脉宽度以及患者的一般情况。结果 12例患者中有11例成功进行了部分脾动脉栓塞,栓塞范围为40%～80%,术后外周血血小板及白细胞明显增高,脾动脉血流量降低明显,脾及门静脉宽度减小,术后常见左上腹疼痛、发热、恶心及呕吐等症状,经对症治疗均好转。结论部分性脾动脉栓塞治疗肝硬化并发的脾功能亢进能有效改善患者外周血象,是一种损伤小,安全性高,疗效快的有效方法,值得临床推广应用。

The Therapeutic Effect of Partial Spietilc Embolization in Patients with Hypersplenism

Objective To discuss the curative effect of partial spleen embolization for hypersplenism in liver cirrhosis. Methods 12 cases who have diagnosed as hepatitis B with hemocytes reduction are selected. With the help of CT and B-mode B-mode ultrasound the patients were diagnosis of enlarged spleen. Partial splenic artery embolization was performed in 12cases with hypersplenism with Seldinger technique. The blood cell , hemoeytes, platelets,the depth of spleen ,the width of Portal Vein, generral conditions of patients was counted after operation. Results Partial splenic embolization was execute in 12 cases,with 11 cases curative effect. The embolism range was 40% to 80%,peripheral blood cell significantly higher than the preoperative cells. It can not only decrease splenic artery blood flow volume but also narrow the depth of spleen and the width of Portal Vein .With occurrence of Such complication： epigastric pain, fever, nausea, vomiting. These symptoms will improve after the symptomatic treatment. Conclusions Partial spleen embolization for hypersplenism in liver cirrhosis is safe .it can not only heighten peripheral blood, reduce trauma, but also elevate quality of life. This operation deserves generalization.