部分脾栓塞术治疗脾功能亢进36例临床分析

目的 讨论部分脾栓塞术（partial splenic embolization,PSE）治疗脾功能亢进的栓塞程度与临床疗效及并发症的关系.方法 对36例脾功能亢进患者行PSE治疗,观察术后并发症及术后3天、7天、1个月、3个月外周血白细胞、红细胞、血小板变化与栓塞程度的关系.结果 成功实施手术的36例患者术后均有不同程度的并发症,术后外周血WBC,RBC,PLT均有不同程度的升高,术前与术后1个月数值比较均有统计学意义（WBCt =2.751,P＜0.05,RBCt=1.960,P＜0.05,PLTt =3.435,P＜0.05）.并发症的程度、血细胞的改善程度与栓塞程度呈正相关.结论 PSE是治疗脾功能亢进安全、有效的方法,栓塞程度与临床疗效及并发症均呈正相关.

Partial splenic embolization for the treatment of hypersplenism: a clinical analysis of 36 cases

Objective To observe the correlation between clinical efficacy, extent of embolization and complication after treating hypersplenism with Partial splenic embolization （PSE）. Methods A total of 36 patients with hypersplenism were treated with PSE. The postoperative complication was observed. The change of white blood cell （WBC）, red blood cell （RBC） and platelet （PLT） counts were recorded after 3 days, 7 days, 1 month and 3 months. The extent of embolization was estimated. The correlation among them was analyzed. Results A total of 36 patients with hypersplenism were suc- cessfully treated with PSE. Different degrees of complication occurred after operation. The number of WBC, RBC and PLT increased in different degrees after operation. The difference of blood cell number between preoperative and postoper- ative for a month were significant （WBC t =2. 751, P〈0.05, RBC t =1. 960, P〈0.05, PLT t =3. 435, P〈0.05）. There was a positive correlation between the degree of embolization and the degree of complication and blood cellular chan- ges. Conclusion PSE is a safe and effective method to treat the hypersplenism. There was a positive correlation among the degree of embolization and clinical efficacy and the degree of complication.